Individual
KIMBERLY JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 SAINT LOUIS AVE, SUITE 102, FORT WORTH, TX 76104-3366
(817) 921-5020
(817) 921-5022
Mailing address
305 NE LOOP 820, BUSINESS TOWER 1, SUITE 200, HURST, TX 76053-7209
(817) 292-8787
(817) 789-6849
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213185
TX
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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