Individual
DONNA KETTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 MOORES LN, TEXARKANA, TX 75503-5102
(903) 223-0282
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
TX
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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