Individual
KATHLEEN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1006 ALLANDALE CIR, KINGSPORT, TN 37660-9002
(423) 292-1299
Mailing address
1006 ALLANDALE CIR, KINGSPORT, TN 37660-9002
(423) 292-1299
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1256
TN
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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