Individual
KIMBERLY BERTHOLD JERROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5125 MICHAUX RD, GREENSBORO, NC 27410-9836
(828) 774-5222
Mailing address
3805 BAYLOR ST, GREENSBORO, NC 27405-3101
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11521
NC
225X00000X
Occupational Therapist
OT16933
FL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11521
NCBOT
NC
Enumeration date
08/11/2015
Last updated
12/21/2022
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