Provider Demographics
NPI:1700241668
Name:ACKERSON, KIMBERLY LOUISE (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:ACKERSON
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LOUISE
Other - Last Name:THORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:193 SAM LISENBY RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-3048
Mailing Address - Country:US
Mailing Address - Phone:334-445-6336
Mailing Address - Fax:
Practice Address - Street 1:193 SAM LISENBY RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3048
Practice Address - Country:US
Practice Address - Phone:334-445-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-19
Last Update Date:2015-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics