Provider Demographics
NPI:1962750109
Name:DAY, KIMBERLY A (OT R/L)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:DAY
Suffix:
Gender:F
Credentials:OT R/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT R/L
Mailing Address - Street 1:1795 ALYSHEBA WAY STE 2102
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2286
Mailing Address - Country:US
Mailing Address - Phone:859-339-4235
Mailing Address - Fax:859-440-4984
Practice Address - Street 1:1795 ALYSHEBA WAY STE 2102
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2286
Practice Address - Country:US
Practice Address - Phone:859-339-4235
Practice Address - Fax:859-440-4980
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR5324225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist