Individual
KIMBERLY JO MADRIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
101 W 87TH AVE, MERRILLVILLE, IN 46410-6177
(219) 756-0744
Mailing address
101 W 87TH AVE, MERRILLVILLE, IN 46410-6177
(219) 756-0744
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002641A
IN
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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