| Doctor Name: | MRS. KIMBERLY MARIE MIREK |
| NPI Number: | 1366440422 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC-SLP |
| License Number: | 146007081 |
| Business Practice Address: | 4214 Sheridan Rd Racine, WI - 534034142 |
| Business Phone Number: | 2625152434 |
| Business Fax Number: | |
| Mailing Address: | 4736 W Forest Home Ave, MILWAUKEE |
| State: | WI |
| Postal Code: | 532194716 |
| Phone Number: | 4143061410 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 07/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 146007081 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| 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 |