Individual
LISA KENNEY-OLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 MOORES LN, TEXARKANA, TX 75503-5102
(903) 223-1805
Mailing address
5613 DEERWOOD DR, TEXARKANA, AR 71854-8296
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210549
TX
Other
Enumeration date
10/30/2009
Last updated
10/30/2009
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