Individual
KIMBERLY WALTERS BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6000 FAYETTEVILLE RD, DURHAM, NC 27713-9754
(919) 544-9021
Mailing address
2530 BARWICK DR, DURHAM, NC 27704-4006
(919) 451-5100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7438
NC
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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