Provider Demographics
NPI:1750771416
Name:DUETSCH, KIMBERLY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:DUETSCH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SKILES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7321
Mailing Address - Country:US
Mailing Address - Phone:610-455-4040
Mailing Address - Fax:855-215-8777
Practice Address - Street 1:200 SKILES BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7321
Practice Address - Country:US
Practice Address - Phone:610-455-4040
Practice Address - Fax:855-215-8777
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0001548225X00000X
PAOC013589225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist