Doctor Name: | KIMBERLEY WILSON KIDD |
NPI Number: | 1629110408 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.L. |
License Number: | LL00001796 |
Business Practice Address: | 2700 152nd Ave Ne Redmond, WA - 980525543 |
Business Phone Number: | 4258835693 |
Business Fax Number: | 4258835929 |
Mailing Address: | Po Box 34584, SEATTLE |
State: | WA |
Postal Code: | 981241584 |
Phone Number: | 5092417349 |
Fax Number: | 5092417628 |
NPI Enumeration Date: | 02/12/2007 |
NPI Last Update Date: | 10/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL00001796 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |