Individual
KATHLEEN GAINOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
300 W HIGHWAY 6, WACO, TX 76712
(254) 761-8500
Mailing address
2502 BACON RANCH RD APT 602, KILLEEN, TX 76542-2912
(440) 915-5994
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213770
TX
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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