Provider Demographics
NPI:1659728103
Name:KIMBERLY D. DOZIER, OTR/L, INC
Entity Type:Organization
Organization Name:KIMBERLY D. DOZIER, OTR/L, INC
Other - Org Name:SUNRISE THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DOZIER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:270-402-2306
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:270-402-2306
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:270-402-2306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-14
Last Update Date:2016-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYR2631252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency