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General NPI Number Information
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NPI Number | 1366570566
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Entity Type | Individual
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Provider Name | DEBBIE KISS
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3421 W DAVIS ST SUITE 210
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City | CONROE
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State | TX
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Zip | 77304-1890
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Country | US
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Telephone | 979-822-6467
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Fax | 979-821-9448
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Provider Business Mailing Address
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Address Line | 302 E. 24TH ST. P.O. BOX 4588
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City | BRYAN
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State | TX
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Zip | 77805-4588
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Country | US
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Telephone | 979-822-6467
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Fax | 979-821-9448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 109356
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License Number State | TX
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