Individual
BAILEY ANN KIBSGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
420 W FARLEY AVE, LAURENS, SC 29360-3039
(864) 984-9844
Mailing address
5209 CINELLI ST, GREENVILLE, SC 29615-4278
(641) 529-0438
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5282
SC
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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