Doctor Name: | KIMBERLY ANN SAMS |
NPI Number: | 1023456993 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-A/SLP |
License Number: | 000286180 |
Business Practice Address: | 65 Ridgecrest Rd Jackson, TN - 383052359 |
Business Phone Number: | 7316686076 |
Business Fax Number: | 7316687033 |
Mailing Address: | 65 Ridgecrest Rd, JACKSON |
State: | TN |
Postal Code: | 383052359 |
Phone Number: | 7316686076 |
Fax Number: | 7316687033 |
NPI Enumeration Date: | 06/12/2013 |
NPI Last Update Date: | 06/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 000286180 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
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 |