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Kimberly Gresham, OTR

Occupational Therapist in Tyler, TX. Individual provider (NPI-1).

NPI number1063899862
StatusActive
Last updated in NPPESApr 30, 2015

Details

NPI
1063899862
Entity type
Individual (NPI-1)
Name
Kimberly Gresham
Credential
OTR
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 30, 2015
Last updated
Apr 30, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist114603TXYes

Practice location

1001 Wsw Loop 323
Tyler, TX 75701-9416

Phone 903-509-1313 · Fax 903-509-1383

Mailing address

612 E Twin Creeks Trl
Troup, TX 75789-6708

Phone 936-556-3756

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