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General NPI Number Information
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NPI Number | 1790238806
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Entity Type | Individual
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Provider Name | KIMBERLY ELAINE WIER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 1201 HIGHWAY 49 S STE 2
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City | RICHLAND
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State | MS
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Zip | 39218-9438
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Country | US
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Telephone | 769-233-8844
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Fax | 769-251-1825
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Provider Business Mailing Address
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Address Line | 199 N BROOKMOORE DR
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City | COLUMBUS
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State | MS
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Zip | 39705-2024
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Country | US
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Telephone | 662-327-6705
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Fax | 662-327-6760
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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 | OT1830
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License Number State | MS
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