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NPI 1093044158

NPI 1093044158 : KIMBERLY M STEVENS OTR/L : AURORA, NY

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General NPI Number Information
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    NPI Number           |    1093044158
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    Entity Type          |    Individual 
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    Provider Name        |    KIMBERLY M STEVENS OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/18/2009
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    Last Update Date     |    08/08/2024
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Provider Practice Location Address
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    Address Line         |    2384 STATE ROUTE 34B 
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    City                 |    AURORA
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    State                |    NY
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    Zip                  |    13026-9743
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    Country              |    US
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    Telephone            |    315-406-2675
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3526 OLD SALT RD 
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    City                 |    MORAVIA
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    State                |    NY
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    Zip                  |    13118-2211
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    Country              |    US
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    Telephone            |    315-406-2675
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    Fax                  |    315-364-8016
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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       |    015931-1
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    License Number State |    NY
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