Doctor Name: | MS. KIMBERLY MUCKLEROY |
NPI Number: | 1821235227 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC/SLP |
License Number: | 12119912 |
Business Practice Address: | 10496 E Pinewood Ave Englewood, CO - 801115472 |
Business Phone Number: | 7204829921 |
Business Fax Number: | |
Mailing Address: | 603 Old State Rd, BAILEY |
State: | CO |
Postal Code: | 804211850 |
Phone Number: | 3034758047 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2009 |
NPI Last Update Date: | 01/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12119912 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
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 |