Provider Demographics
NPI:1568268811
Name:SKINNER, KIMBERLY MARI (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MARI
Last Name:SKINNER
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03216-3615
Mailing Address - Country:US
Mailing Address - Phone:603-315-7510
Mailing Address - Fax:
Practice Address - Street 1:200 DERRY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-3398
Practice Address - Country:US
Practice Address - Phone:603-886-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1250225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics