Individual
MRS. KIMBERLY CHARISE BRYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
906 THOMPSON ST, ASHLAND, VA 23005-1128
(804) 798-3291
Mailing address
4015 N HUGUENOT RD, RICHMOND, VA 23235-1609
(804) 519-6509
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000326
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131000326
BOARD OF MEDICINE
VA
01
—
1021312
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
MD
Enumeration date
02/10/2013
Last updated
02/10/2013
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