Provider Demographics
NPI:1467528448
Name:TREPANIER, KIMBERLY JANE (PT, CWS)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JANE
Last Name:TREPANIER
Suffix:
Gender:F
Credentials:PT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 LEE OAKS PL APT 102
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-7339
Mailing Address - Country:US
Mailing Address - Phone:860-485-3579
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR ROAD, NW, BLES G-12
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-444-4180
Practice Address - Fax:202-444-5333
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist