Provider Demographics
NPI:1265654917
Name:DOZIER, KIMBERLY D (OTRL)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:DOZIER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5563 BRADFORDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40009-8904
Mailing Address - Country:US
Mailing Address - Phone:270-789-1703
Mailing Address - Fax:
Practice Address - Street 1:5563 BRADFORDSVILLE RD
Practice Address - Street 2:
Practice Address - City:BRADFORDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40009-8904
Practice Address - Country:US
Practice Address - Phone:270-789-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R2631225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics