Individual
CORINNE KIMBRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2929 5TH AVE NE STE A, PUYALLUP, WA 98372-6782
(253) 447-8216
Mailing address
4412A ASH ST SW, MCCHORD AFB, WA 98439-1402
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
60904449
WA
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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