Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT13038 | FL |
NPI | 1003130337 |
---|---|
Provider Name | Mrs. Kimberly Rae Reynolds |
First Address | Gainesville, FL 32607-7611 |
Second Address | Gainesville, FL 32607-7611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2010 |
Last Update Date | 15/03/2010 |