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General NPI Number Information
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NPI Number | 1407000110
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Entity Type | Individual
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Provider Name | KATHERINE ANNE HUMBERT OTR
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Gender | Female
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 101 WATERMERE DRIVE
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City | SOUTHLAKE
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State | TX
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Zip | 76092
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Country | US
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Telephone | 817-431-8668
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Fax | 817-337-7622
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Provider Business Mailing Address
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Address Line | 338 INVERNESS DR
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City | TROPHY CLUB
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State | TX
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Zip | 76262-9749
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Country | US
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Telephone | 817-430-8059
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Fax |
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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 | 002622
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License Number State | TX
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