Individual
KRISTINA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7206 BRIGHTON ROAD, BEN AVON, PA 15202
(412) 734-4675
Mailing address
7206 BRIGHTON RD, BEN AVON, PA 15202-1903
(412) 734-4675
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC006906L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OC006906L
OT LISCENSURE
PA
Enumeration date
11/04/2008
Last updated
11/04/2008
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