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Individual

KIMBERLY M. DAVID

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 288-5711
Mailing address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 288-5711

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2001031926
MO
225X00000X
Occupational Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KD63741102P
EARLY INTERVENTION
IL
Enumeration date
10/23/2006
Last updated
07/08/2007
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