Individual
NICOLE LONGORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1400 HILLTOP RD, KERRVILLE, TX 78028-2851
(830) 895-3200
Mailing address
1138 WARBLER DR, KERRVILLE, TX 78028-2962
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209655
TX
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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