Individual
KIMBERLIE ANN PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
13209 FOUNTAIN DR, WATERFORD, CA 95386-8858
(808) 937-3172
Mailing address
13209 FOUNTAIN DR, WATERFORD, CA 95386-8858
(808) 937-3172
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60114073
WA
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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