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Individual

KIMBERLY DESLAURIERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
473 NEWGATE ST NW, PALM BAY, FL 32907-2929
(321) 409-0072
Mailing address
473 NEWGATE ST NW, PALM BAY, FL 32907-2929

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 12192
FL

Other

Enumeration date
03/07/2013
Last updated
03/07/2013
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