Provider Demographics
NPI:1508081357
Name:BECK, KIMBERLY KANZLEITER (OCCUPATIONAL THERAPY)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KANZLEITER
Last Name:BECK
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-7242
Mailing Address - Country:US
Mailing Address - Phone:828-584-7241
Mailing Address - Fax:
Practice Address - Street 1:201 BRIGHT ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-7242
Practice Address - Country:US
Practice Address - Phone:828-584-7241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0758174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist