Individual
KACIE LORENE CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 E HENDERSON ST, BULLARD, TX 75757-5444
(903) 658-2292
Mailing address
1030 E HENDERSON ST, BULLARD, TX 75757-5444
(903) 658-2292
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209440
TX
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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