Individual
KASSIDY GREVEMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2000 W BAKER RD, BAYTOWN, TX 77521-2259
(281) 427-9120
Mailing address
21308 HERITAGE FOREST LN, PORTER, TX 77365-5196
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211867
TX
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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