Individual
KELSIE MAE WALTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
3401 AMADOR DR, FORT WORTH, TX 76177-2227
(682) 204-0853
Mailing address
204 CREEKWOOD RANCH RD, AZLE, TX 76020-8047
(719) 355-6292
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216827
TX
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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