Healthcare Provider Details

I. General information

NPI: 1134409469
Provider Name (Legal Business Name): JAMIE LYNN KIRMAN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2114 HALE DRIVE
HARLINGEN TX
78550
US

IV. Provider business mailing address

2114 HALE DRIVE
HARLINGEN TX
78550
US

V. Phone/Fax

Practice location:
  • Phone: 956-365-4106
  • Fax: 956-365-4126
Mailing address:
  • Phone: 956-365-4106
  • Fax: 956-365-4126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number109974
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: