Healthcare Provider Details

I. General information

NPI: 1164118105
Provider Name (Legal Business Name): KIMBERLY HUANG OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1497 S QUEEN ST
YORK PA
17403-3852
US

IV. Provider business mailing address

1497 S QUEEN ST
YORK PA
17403-3852
US

V. Phone/Fax

Practice location:
  • Phone: 717-430-8896
  • Fax:
Mailing address:
  • Phone: 717-430-8896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: