Individual
KAYLA CHRISTINA LYNN WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 TX -11 LOOP, WICHITA FALLS, TX 76306
(940) 723-8420
Mailing address
3919 BARNETT RD APT 1327, WICHITA FALLS, TX 76310-1743
(806) 570-4497
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214549
TX
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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