Individual
KIMBERLY SCANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1 OAKWOOD BLVD STE 130, HOLLYWOOD, FL 33020-1937
(954) 925-3844
Mailing address
2301 SW 85TH WAY, DAVIE, FL 33324-5360
(501) 388-3528
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
19787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889063300
—
FL
Enumeration date
02/11/2019
Last updated
02/16/2019
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