| Doctor Name: | KIMBERLY TICE |
| NPI Number: | 1942512652 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | 020090-1 |
| Business Practice Address: | 2685 Executive Park Dr Suite 5 Weston, FL - 333313651 |
| Business Phone Number: | 9543729710 |
| Business Fax Number: | |
| Mailing Address: | 2350 Nw 33rd St, Apt 802 OAKLAND PARK |
| State: | FL |
| Postal Code: | 333096460 |
| Phone Number: | 5162790234 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2010 |
| NPI Last Update Date: | 12/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 020090-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| 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 |