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General NPI Number Information
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NPI Number | 1598238198
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Entity Type | Individual
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Provider Name | KIMBERLY J BIRDSALL OTR
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Gender | Female
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 3186 MAIN ST
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City | EXMORE
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State | VA
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Zip | 23350
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Country | US
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Telephone | 757-442-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 15 AMES ST
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City | ONANCOCK
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State | VA
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Zip | 23417-1804
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Country | US
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Telephone | 732-597-0251
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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 | 0119007754
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License Number State | VA
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