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General NPI Number Information
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NPI Number | 1033122429
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Entity Type | Individual
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Provider Name | SUSAN KAY KIME OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1020 E MISSOURI AVE
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City | PHOENIX
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State | AZ
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Zip | 85014-2615
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Country | US
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Telephone | 602-570-2552
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Fax | 602-271-4799
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Provider Business Mailing Address
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Address Line | 2610 N 20TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85009-1937
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Country | US
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Telephone | 602-570-2552
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Fax | 602-271-4799
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0210
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License Number State | AZ
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