Individual
KIMBERLY BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4260 BUCKSKIN LAKE DR, ELLICOTT CITY, MD 21042-1254
(443) 820-8934
Mailing address
4260 BUCKSKIN LAKE DR, ELLICOTT CITY, MD 21042-1254
(443) 820-8934
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A00636
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A00636
IONAL THERAPY
MD
Enumeration date
01/20/2015
Last updated
07/10/2026
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