Individual
MRS. KOURTNY MARIE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1001 WSW LOOP 323, TYLER, TX 75701-9416
(903) 509-1313
Mailing address
1001 WSW LOOP 323, TYLER, TX 75701-9416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212445
TX
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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