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NPI 1902614894

NPI 1902614894 : KIMBERLY SCHOR OT : WATERBURY, CT

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General NPI Number Information
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    NPI Number           |    1902614894
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    Entity Type          |    Individual 
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    Provider Name        |    KIMBERLY SCHOR OT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/23/2024
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    Last Update Date     |    12/23/2024
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Provider Practice Location Address
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    Address Line         |    715 LAKEWOOD RD 
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    City                 |    WATERBURY
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    State                |    CT
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    Zip                  |    06704-5400
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    Country              |    US
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    Telephone            |    203-759-1122
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    Fax                  |    203-596-9882
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Provider Business Mailing Address
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    Address Line         |    22 TOMPKINS ST 
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    City                 |    WATERBURY
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    State                |    CT
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    Zip                  |    06708-1458
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    Country              |    US
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    Telephone            |    203-419-0381
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    Fax                  |    203-419-0389
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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       |    6570
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    License Number State |    CT
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