Provider Demographics
NPI:1235640350
Name:KIMMINS, EMILY M E (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M E
Last Name:KIMMINS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6745 SE STATE FARM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-9029
Mailing Address - Country:US
Mailing Address - Phone:252-725-9456
Mailing Address - Fax:
Practice Address - Street 1:1600 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-4444
Practice Address - Country:US
Practice Address - Phone:843-812-1958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5531225X00000X
NE2232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist