Individual
NYDA KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
436A W 1ST NORTH ST, MORRISTOWN, TN 37814-4641
(423) 586-1214
(423) 587-8136
Mailing address
436A W 1ST NORTH ST, MORRISTOWN, TN 37814-4641
(423) 586-1214
(423) 587-8136
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2742
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3718146
—
TN
Enumeration date
02/18/2007
Last updated
07/08/2007
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