Provider Demographics
NPI:1942273024
Name:DEHN, KIMBERLY SUE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUE
Last Name:DEHN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:SUE
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4000 JACOBSGAARD LN
Mailing Address - Street 2:
Mailing Address - City:CAMINO
Mailing Address - State:CA
Mailing Address - Zip Code:95709-9107
Mailing Address - Country:US
Mailing Address - Phone:530-295-3948
Mailing Address - Fax:
Practice Address - Street 1:4000 JACOBSGAARD LN
Practice Address - Street 2:
Practice Address - City:CAMINO
Practice Address - State:CA
Practice Address - Zip Code:95709-9107
Practice Address - Country:US
Practice Address - Phone:530-295-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20550262251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic