Healthcare Provider Details

I. General information

NPI: 1528345709
Provider Name (Legal Business Name): KIMBERLY ANN HEWITT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9784 OTTERBEIN RD
CINCINNATI OH
45241-3338
US

IV. Provider business mailing address

9784 OTTERBEIN RD
CINCINNATI OH
45241-3338
US

V. Phone/Fax

Practice location:
  • Phone: 513-226-3521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT 003389
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number103977
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: