Doctor Name: | KIMBERLY A ABUSHAKRA |
NPI Number: | 1013160134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 4303 |
Business Practice Address: | 128 Highway 17 S North Myrtle Beach, SC - 295823118 |
Business Phone Number: | 8432803755 |
Business Fax Number: | |
Mailing Address: | 1701 Lake Tree Dr Sw, OCEAN ISLE BEACH |
State: | NC |
Postal Code: | 284694762 |
Phone Number: | 8432803755 |
Fax Number: | |
NPI Enumeration Date: | 11/03/2008 |
NPI Last Update Date: | 11/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4303 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |