Provider Demographics
NPI:1720287311
Name:ARNETT-DESIMONE, KIMBERLEY KAYE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:KAYE
Last Name:ARNETT-DESIMONE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KIMBERLEY
Other - Middle Name:
Other - Last Name:ARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:16615 BEECH HILL DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-8734
Mailing Address - Country:US
Mailing Address - Phone:714-425-8924
Mailing Address - Fax:704-951-5148
Practice Address - Street 1:10224 HICKORYWOOD HILL AVE STE 101B
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3471
Practice Address - Country:US
Practice Address - Phone:704-251-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15466225XP0200X
CA2318225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics