Kimberly Dean Patterson

Individual provider Active NPI Developmental Therapist · Eminence, KY

NPI 1861355307 · NPPES record last updated Dec 3, 2025

Key facts

NPI
1861355307
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
License
200101930 (KY)
Practice address
67 Oldham St
Eminence, KY 40019-1337
Phone
(502) 321-0299
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
200101930KYMDDevelopmental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
222Q00000X 200101930 KY Yes

Addresses

Primary practice location

67 Oldham St
Eminence, KY 40019-1337

Mailing address

67 Oldham St
Eminence, KY 40019-1337

Other providers in Eminence, KY

All providers in Eminence, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.