Individual
MRS. KIMBERLY ANN MANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
100 HINMAN ST, CHESHIRE, CT 06410
(203) 250-0305
(203) 758-0754
Mailing address
124 NORTHWOOD DR, MIDDLEBURY, CT 06762
(860) 919-1222
(203) 758-0754
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1841
CT
225XP0200X
Pediatric Occupational Therapist
001841
CT
Other
Enumeration date
02/14/2009
Last updated
09/02/2022
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