KIMBERLY DIANE BOULLARD

PROVIDENCE, RI
NPI1770603862
Former NameKIMBERLY DIANE BACKUNAS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: RI  OT 01140)
Enumeration Date2007-03-30
Last Update Date2007-07-08
Business Address
MS. KIMBERLY DIANE BOULLARD OTR
1000 EDDY STREET
PROVIDENCE, RI 02905
Phone number: 401-533-9100
Mailing Address
MS. KIMBERLY DIANE BOULLARD OTR
9-1 TUCK FARM RD
AUBURN, MA 01501-2455
Phone number: 508-832-8041
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