Individual
KIMBERLY R HARROLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
34 W ADAMS DR, CAHOKIA, IL 62206-3113
(314) 226-8811
Mailing address
34 W ADAMS DR, CAHOKIA, IL 62206-3113
(314) 226-8811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011014123
MO
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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