Kimberly Brodeur
Individual provider Active NPI Occupational Therapy Assistant · Colchester, CT
NPI 1487030573 · NPPES record last updated Jul 31, 2015
Key facts
- NPI
- 1487030573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 000332 (CT)
- Practice address
- 59 Harrington CT
Colchester, CT 06415-1207 - Phone
- (860) 531-7021
- NPI assigned
- Jul 31, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000332 | CT | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 000332 | CT | Yes |
Addresses
Primary practice location
59 Harrington CT
Colchester, CT 06415-1207
Mailing address
59 Harrington CT
Colchester, CT 06415-1207
Other providers in Colchester, CT
- James Vincent Bianchi III
- Jane Bishow-Semevolos
- Lily Blanchette
- Mallory Simpson Breitmaier
- Pamela Jean Broadwell
- Kayleigh Browne
- James George Bucci
- Sally Scruggs Buller
- Kirsten Taylor Burdick
- Rebecca Burrell
All providers in Colchester, CT · Occupational Therapy Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.