Most Relevant Information
Provider Data
| NPI Number: | 1003588013 |
| Provider Name: | KIMBERLY MARIE THEOBALD MS, OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/29/2021 |
| Last Updated: | 09/29/2021 |
Provider Practice Location
163 E MAIN ST
LITTLE FALLS
NJ
074241711
Practice Location Phone/Fax
| Phone: | 2014031345 |
| Fax: |
Provider Mailing Location
163 E MAIN ST
LITTLE FALLS
NJ
074241711
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |