Individual
KIMBERLY ANN FREBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
400 AUSTIN AVE NW, MASSILLON, OH 44646-3554
(330) 837-7240
Mailing address
5004 PINE PT, STOW, OH 44224-6012
(330) 650-9813
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2411
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002413
AOTCB CERTIFICATION
—
01
—
OT-2411
STATE LICENSE
OH
Enumeration date
05/18/2007
Last updated
07/08/2007
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