Individual
MRS. KIM DENISE BOOKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1306 PELHAM RD, GREENVILLE, SC 29615-3600
(864) 329-1553
Mailing address
5 DRY FORK CT, SIMPSONVILLE, SC 29680-7646
(864) 810-8500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2633
SC
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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