Provider Demographics
NPI:1588737449
Name:TEAMER, KIMBERLY (OT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:TEAMER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:1200 LAKE HEARN DR NE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1454
Mailing Address - Country:US
Mailing Address - Phone:404-943-1070
Mailing Address - Fax:
Practice Address - Street 1:1200 LAKE HEARN DR NE STE 250
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-1454
Practice Address - Country:US
Practice Address - Phone:770-367-2497
Practice Address - Fax:404-943-0890
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT001827225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist