Provider Demographics
NPI:1467712935
Name:POOL, KASEY ROGNER (OTR)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:ROGNER
Last Name:POOL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:NICHOLE
Other - Last Name:ROGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:12606 GREENVILLE AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1927
Mailing Address - Country:US
Mailing Address - Phone:972-490-9055
Mailing Address - Fax:972-490-9058
Practice Address - Street 1:320 CUSTER RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-490-9055
Practice Address - Fax:972-490-9058
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist