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NPI Code Detail

MEDICARE: DR. KIMBERLY DACHE DALE DOT

MEDICARE: DR. KIMBERLY DACHE DALE DOT
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 Therapist056008963IL

General Provider Information

NPI Number : 1659682326
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY DACHE DALE DOT
Provider Business Mailing Address
First Line : 620 JOHNSON HILL RD
Second Line : APT. B
City : COLLINSVILLE
State : IL
Zip : 62234-6039
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 515 N JEFFERSON AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63103-3000
Country : US
Telephone Number : 314-652-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2010
Last Update Date : 11/01/2013

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Directions to “ DR. KIMBERLY DACHE DALE DOT” Practice Location

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