Individual
DAKOTA KYLIE THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
267 W END RD, ROCKWOOD, TN 37854-7041
(630) 408-5845
(480) 687-4930
Mailing address
267 W END RD, ROCKWOOD, TN 37854-7041
(630) 408-5845
(480) 687-4930
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6882
TN
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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