Doctor Name: | MRS. KIMBERLY ANNE PORTER |
NPI Number: | 1154501518 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SP 5070-SL |
Business Practice Address: | 31 Lake St Gardner, MA - 014403879 |
Business Phone Number: | 9786324432 |
Business Fax Number: | 9786326022 |
Mailing Address: | 31 Lake St, GARDNER |
State: | MA |
Postal Code: | 014403879 |
Phone Number: | 9786324432 |
Fax Number: | 9786326022 |
NPI Enumeration Date: | 11/13/2007 |
NPI Last Update Date: | 12/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP 5070-SL |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
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 |