Individual
KIMBERLY DETRIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
125 S SWOOPE AVE STE 210, MAITLAND, FL 32751-5784
(321) 972-4122
(407) 542-2168
Mailing address
125 S SWOOPE AVE STE 210, MAITLAND, FL 32751-5784
(321) 972-4122
(407) 542-2168
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10512
FL
Other
Enumeration date
03/26/2020
Last updated
01/29/2025
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