Provider Demographics
NPI:1588700934
Name:DOTY, KIMBERLY LYNN (MS OTR)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:DOTY
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:320 SPRING CREEK DR
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-1665
Mailing Address - Country:US
Mailing Address - Phone:607-738-3112
Mailing Address - Fax:
Practice Address - Street 1:ST. JOSEPH'S HOSPITAL
Practice Address - Street 2:555 EAST MARKET STREET
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901
Practice Address - Country:US
Practice Address - Phone:607-733-6541
Practice Address - Fax:607-737-1532
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011732225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist