Individual
KIRSTEN WOOLSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
2330 TRISTON ST, ANNA, TX 75409-5819
(757) 589-5724
Mailing address
2330 TRISTON ST, ANNA, TX 75409-5819
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
62504
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62504
CERTIFIED THERAPEUTIC RECREATION SPECIALIST
—
Enumeration date
06/17/2018
Last updated
06/17/2018
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