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Individual

KIMBERLY A CASSIDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11160 HURON ST STE 200, NORTHGLENN, CO 80234-3335
(720) 872-6472
Mailing address
11160 HURON ST STE 200, NORTHGLENN, CO 80234-3335

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0000725
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA.0000725
LICENSE
CO
Enumeration date
10/08/2019
Last updated
10/08/2019
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