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General NPI Number Information
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NPI Number | 1336867704
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Entity Type | Individual
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Provider Name | KIMBERLY RODRIGUEZ OTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 6045 STEVENS FOREST RD
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City | COLUMBIA
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State | MD
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Zip | 21045-3828
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Country | US
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Telephone | 410-313-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 35 ARVERNE CT
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-3052
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 07499
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License Number State | MD
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