Individual
ANNIE GRACE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
12121 SHADOW RIDGE WAY, NORTHRIDGE, CA 91326-3826
(818) 606-6902
Mailing address
12121 SHADOW RIDGE WAY, NORTHRIDGE, CA 91326-3826
(818) 606-6902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12932
CA
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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