Provider Demographics
NPI:1194308361
Name:KORNER, KRISTEN MARJORIE (OTD, OTR/L)
Entity type:Individual
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First Name:KRISTEN
Middle Name:MARJORIE
Last Name:KORNER
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Gender:F
Credentials:OTD, OTR/L
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8101 BOAT CLUB RD STE 330
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3633
Mailing Address - Country:US
Mailing Address - Phone:682-498-3982
Mailing Address - Fax:214-935-2457
Practice Address - Street 1:1140 W PIONEER PKWY STE 330
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6390
Practice Address - Country:US
Practice Address - Phone:469-587-9397
Practice Address - Fax:214-935-2457
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2024-06-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics