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General NPI Number Information
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NPI Number | 1265867790
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Entity Type | Individual
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Provider Name | KIMBERLY ROBERTS PERKS OTR
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Gender | Female
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 3200 MILITARY RD NW
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City | WASHINGTON
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State | DC
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Zip | 20015
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Country | US
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Telephone | 301-922-6177
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Fax |
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Provider Business Mailing Address
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Address Line | 9521 OLD CREEK DR
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City | FAIRFAX
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State | VA
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Zip | 22032
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Country | US
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Telephone |
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Fax |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT100000116
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 0119002926
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License Number State | VA
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