Individual
MRS. KIMBERLY KAY PHILBRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3209 ALDER CT, TEGA CAY, SC 29708-8615
(407) 484-5504
Mailing address
3209 ALDER CT, TEGA CAY, SC 29708-8615
(407) 484-5504
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT8473
FL
225XP0200X
Pediatric Occupational Therapist
3974
SC
225XP0200X
Pediatric Occupational Therapist
Primary
8511
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884295700
—
FL
Enumeration date
04/03/2006
Last updated
02/12/2013
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