Individual
KIMBERLY SUMNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
250 STATE ST, BREWER, ME 04412-1519
(207) 947-8493
Mailing address
250 STATE ST, BREWER, ME 04412-1519
(207) 947-8493
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA2470
ME
Other
Enumeration date
12/22/2010
Last updated
12/22/2010
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