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NPI Code Detail

MEDICARE: KIMBERLY RODRIGUEZ OTR/L, CLT

MEDICARE: KIMBERLY RODRIGUEZ OTR/L, CLT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist07499MD

General Provider Information

NPI Number : 1336867704
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY RODRIGUEZ OTR/L, CLT
Provider Business Mailing Address
First Line : 35 ARVERNE CT
Second Line :
City : LUTHERVILLE TIMONIUM
State : MD
Zip : 21093-3052
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6045 STEVENS FOREST RD
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-3828
Country : US
Telephone Number : 410-313-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 08/22/2022

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Directions to “ KIMBERLY RODRIGUEZ OTR/L, CLT” Practice Location

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