Individual
CLARA TIBBITTS KORNOVICH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 MEDICAL DR, LAKEWAY, TX 78734-4200
(504) 952-2893
Mailing address
2000 MEDICAL DR, LAKEWAY, TX 78734-4200
(504) 952-2893
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
124782
TX
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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