Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 109107 | TX |
NPI | 1114124526 |
---|---|
Provider Name | Ms. Kathleen J Kimberlin |
First Address | Spring, TX 77386-1510 |
Second Address | Pasadena, TX 77504-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 08/07/2007 |