Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003812587 |
---|---|
Provider Name | Kimberly A Howard |
First Address | Wheeling, WV 26003-0808 |
Second Address | Wheeling, WV 26003-5705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7502157000 | (05) | WV |
Q36903 | (02) |