Individual
MS. KIMBERLEY ANN MARIETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
16 LAKE HUNTER DR, LAKELAND, FL 33803-1297
(863) 513-7588
Mailing address
2715 EASTON TER, LAKELAND, FL 33803-3219
(863) 680-1337
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT8405
FL
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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