Provider Demographics
NPI:1770633448
Name:BOOHER, KRISTIN L (OT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:BOOHER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:HARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12727 KIMBERLEY LN STE 104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4060
Mailing Address - Country:US
Mailing Address - Phone:713-365-9338
Mailing Address - Fax:
Practice Address - Street 1:12727 KIMBERLEY LN STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4060
Practice Address - Country:US
Practice Address - Phone:713-365-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist