Individual
KIMBERLY CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4917 RAVENSWOOD DR, SAN ANTONIO, TX 78227-4317
(210) 673-2761
Mailing address
7927 BRAZORIA PARK, SAN ANTONIO, TX 78254-9571
(361) 960-4242
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
120990
TX
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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