Provider Demographics
NPI:1255963617
Name:MCDONALD, KINDLE MOSS (OTR/L)
Entity type:Individual
Prefix:
First Name:KINDLE
Middle Name:MOSS
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KINDLE
Other - Middle Name:BROOK
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3992 E US 64 ALT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6843
Mailing Address - Country:US
Mailing Address - Phone:828-835-7580
Mailing Address - Fax:
Practice Address - Street 1:3992 E US 64 ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6843
Practice Address - Country:US
Practice Address - Phone:828-835-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007543225X00000X
NC12367225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist