Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 163996 | KY |
NPI | 1750855904 |
---|---|
Provider Name | Dr. Kimberly Nicole Walker |
First Address | Bowling Green, KY 42104-7897 |
Second Address | Bowling Green, KY 42104-7897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2019 |
Last Update Date | 21/01/2019 |