Individual
KIMBERLY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
339 E STARDUST DR, PUEBLO WEST, CO 81007-1612
(719) 251-1922
Mailing address
339 E STARDUST DR, PUEBLO WEST, CO 81007-1612
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
12710
NC
224Z00000X
Occupational Therapy Assistant
Primary
23396
—
224Z00000X
Occupational Therapy Assistant
A02969
MD
224Z00000X
Occupational Therapy Assistant
OTA500004
CO
Other
Enumeration date
04/12/2012
Last updated
11/10/2021
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