Individual
MRS. KINETRIA JOVON WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2800 S DIXON RD, KOKOMO, IN 46902-6403
(765) 864-0237
Mailing address
1737 BENNINGTON CT, ANDERSON, IN 46011-3136
(317) 603-6774
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002563A
IN
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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