Individual
MRS. KIMBERLY L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
216 SUNSET PL, NEILLSVILLE, WI 54456-1706
(715) 743-3101
Mailing address
2061 RIVER RD, SPARTA, WI 54656-2386
(608) 630-2598
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2062-27
WI
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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