Healthcare Provider Details

I. General information

NPI: 1306624291
Provider Name (Legal Business Name): KIMBERLY ROYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 SPRINGDALE RD
CINCINNATI OH
45251-1331
US

IV. Provider business mailing address

65 HESTON DR
SPRINGBORO OH
45066-1082
US

V. Phone/Fax

Practice location:
  • Phone: 513-245-0100
  • Fax: 513-245-2372
Mailing address:
  • Phone: 513-722-5234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-1978
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: