Provider Demographics
NPI:1114124526
Name:KIMBERLIN, KATHLEEN J (OTR)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:J
Last Name:KIMBERLIN
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 1:25414 SPRING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1510
Mailing Address - Country:US
Mailing Address - Phone:832-275-6111
Mailing Address - Fax:281-857-6487
Practice Address - Street 1:3915 SHAVER ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2603
Practice Address - Country:US
Practice Address - Phone:713-378-0030
Practice Address - Fax:713-378-0399
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109107225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand