Individual
KATIE L KOYM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4407 N GRANDVIEW AVE, ODESSA, TX 79762-5311
(432) 366-9541
(432) 366-1951
Mailing address
4407 N GRANDVIEW AVE, ODESSA, TX 79762-5311
(432) 366-9541
(432) 366-1951
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
120134
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120134
STATE LICENSE NUMBER
TX
Enumeration date
07/29/2019
Last updated
01/05/2022
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