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General NPI Number Information
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NPI Number | 1528209509
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Entity Type | Individual
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Provider Name | KANISHA SHENELL AIKIN MPT
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Gender | Female
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 21720 KINGSLAND BLVD
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City | KATY
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State | TX
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Zip | 77450-2550
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Country | US
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Telephone | 800-447-3422
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Fax |
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Provider Business Mailing Address
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Address Line | 24715 MASON KNIGHTS CT
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City | KATY
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State | TX
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Zip | 77493-2762
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Country | US
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Telephone | 832-689-8534
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1169492
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License Number State | TX
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