Provider Demographics
NPI:1750924718
Name:CADENA, KIMBERLY (COTA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CADENA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:TX
Mailing Address - Zip Code:78621-2209
Mailing Address - Country:US
Mailing Address - Phone:512-229-7785
Mailing Address - Fax:
Practice Address - Street 1:511 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-2209
Practice Address - Country:US
Practice Address - Phone:512-229-7785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant