Individual
CARLA GUIDRY GRAVENKEMPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8615 FREEPORT PKWY STE 225, IRVING, TX 75063-1984
(972) 812-3299
(866) 861-4265
Mailing address
6437 CASTLEMERE DR, PLANO, TX 75093-8012
(972) 473-9337
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107696
TX
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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