Provider Demographics
NPI:1588999312
Name:RICH, KAREN YVONNE (OTR)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:YVONNE
Last Name:RICH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 N 4TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5143
Mailing Address - Country:US
Mailing Address - Phone:903-753-6635
Mailing Address - Fax:903-753-1114
Practice Address - Street 1:3202 N 4TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5143
Practice Address - Country:US
Practice Address - Phone:903-753-6635
Practice Address - Fax:903-753-1114
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist