Individual
KIMBERLY MIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
850 E BUTLER RD, GREENVILLE, SC 29607-5842
(864) 675-6421
(864) 675-9122
Mailing address
2 BELLSPRING CT, SIMPSONVILLE, SC 29680-7063
(864) 757-1598
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
1326A
SC
Other
Enumeration date
05/15/2011
Last updated
05/15/2011
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