Individual
MRS. KIMBERLY SUE CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Contact information
Practice address
2901 ELLSWORTH RD, NORTONVILLE, KS 66060-5019
(417) 499-1885
(954) 212-2411
Mailing address
2901 ELLSWORTH RD, NORTONVILLE, KS 66060-5019
(417) 499-1885
(954) 212-2411
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1702306
KS
222Q00000X
Developmental Therapist
2005032056
MO
222Q00000X
Developmental Therapist
470
NE
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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