Provider Demographics
NPI:1669165403
Name:GREMAUX, KENDALL ELIZABETH (OTR/L)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:ELIZABETH
Last Name:GREMAUX
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74186 TALLASSEE HWY STE B
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-5644
Mailing Address - Country:US
Mailing Address - Phone:334-478-3570
Mailing Address - Fax:
Practice Address - Street 1:74186 TALLASSEE HWY STE B
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-5644
Practice Address - Country:US
Practice Address - Phone:334-478-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6025225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist