Individual
KRISTIN NICOLE HEREFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
17570 HIGHWAY 105 W UNIT 17, MONTGOMERY, TX 77356-5250
(936) 662-6827
Mailing address
17570 HIGHWAY 105 W UNIT 17, MONTGOMERY, TX 77356-5250
(936) 662-6827
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211018
TX
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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