Provider Demographics
NPI:1861799280
Name:ABERCROMBIE, KIMBERLY ROY (OTR)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ROY
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 HARDING DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-3818
Mailing Address - Country:US
Mailing Address - Phone:504-228-8539
Mailing Address - Fax:
Practice Address - Street 1:922 HARDING DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-3818
Practice Address - Country:US
Practice Address - Phone:504-228-8539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12124225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist