Provider Demographics
NPI:1265654388
Name:PISK, KIMBERLY SIMORA (OTL)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SIMORA
Last Name:PISK
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 PEOPLES DR STE 110
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-7622
Mailing Address - Country:US
Mailing Address - Phone:540-638-2478
Mailing Address - Fax:540-908-4801
Practice Address - Street 1:3221 PEOPLES DR STE 110
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-7622
Practice Address - Country:US
Practice Address - Phone:540-638-2478
Practice Address - Fax:540-908-4801
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000086225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist