Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 6207 | TN |
N | 225XF0002X | Feeding, Eating & Swallowing | 6207 | TN |
N | 225XP0200X | Occupational Therapist - Pediatrics | 6207 | TN |
NPI | 1295295715 |
---|---|
Provider Name | Kimberly Calarco |
First Address | Clarksville, TN 37043-5646 |
Second Address | Clarksville, TN 37040-5257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2019 |
Last Update Date | 21/03/2019 |