| NPI | 1861155517 |
|---|---|
| Former Name | KIMBERLY ANN MCKENNA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131002523) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP009663) |
| 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09179200) | |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |