| Doctor Name: | SHAYNE KIMBLE |
| NPI Number: | 1831504687 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.C.D. CF-SLP |
| License Number: | #7138 |
| Business Practice Address: | 3347 Masonic Dr Alexandria, LA - 713013842 |
| Business Phone Number: | 3184666111 |
| Business Fax Number: | 3184666113 |
| Mailing Address: | 5545 Downing St, ALEXANDRIA |
| State: | LA |
| Postal Code: | 713013159 |
| Phone Number: | 3183598634 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2014 |
| NPI Last Update Date: | 06/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | #7138 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| 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 |