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NPI Code Detail

MEDICARE: MRS. KIMBERLY ARRENA LYNN M.S. CCC-SLP

MEDICARE:  MRS. KIMBERLY ARRENA LYNN  M.S. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist22003581AIN

General Provider Information

NPI Number : 1073798583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY ARRENA LYNN M.S. CCC-SLP
Provider Business Mailing Address
First Line : 8056 S VICTORIA DR
Second Line :
City : FORT BRANCH
State : IN
Zip : 47648-8101
Country : US
Telephone Number : 812-664-2929
Fax Number : 866-756-0806
Provider Business Practice Location Address
First Line : 8056 S VICTORIA DR
Second Line :
City : FORT BRANCH
State : IN
Zip : 47648-8101
Country : US
Telephone Number : 812-664-2929
Fax Number : 866-756-0806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2008
Last Update Date : 01/02/2008

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Directions to “ MRS. KIMBERLY ARRENA LYNN M.S. CCC-SLP” Practice Location

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