Individual
CARRIE KIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
293 ASHFORD DR, MOUNT WASHINGTON, KY 40047-6207
(502) 741-3487
Mailing address
293 ASHFORD DR, MOUNT WASHINGTON, KY 40047-6207
(502) 741-3487
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A4647
KY
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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