Provider Demographics
NPI:1154803187
Name:KIREGU, LINUS MAINA (OCC THERAPIST)
Entity type:Individual
Prefix:
First Name:LINUS
Middle Name:MAINA
Last Name:KIREGU
Suffix:
Gender:M
Credentials:OCC THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 HIGHWAY 418 W
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-3635
Mailing Address - Country:US
Mailing Address - Phone:409-385-0033
Mailing Address - Fax:
Practice Address - Street 1:705 HIGHWAY 418 W
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-3635
Practice Address - Country:US
Practice Address - Phone:409-385-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
TX109240225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist