Individual
KIMBERLY ADDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
11110 TOM ADAMS DR, AUSTIN, TX 78753-3354
(512) 836-1515
Mailing address
9807 N FM 620 RD APT 14210, AUSTIN, TX 78726-2272
(512) 786-5983
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214929
TX
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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