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NPI Code Detail

MEDICARE: MISS KIMBERLY DAWN THOMPSON MS, CCC-SLP

MEDICARE: MISS KIMBERLY DAWN THOMPSON MS, 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 PathologistSP-1354NV
2235Z00000XSpeech-Language Pathologist105049TX

General Provider Information

NPI Number : 1407081284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KIMBERLY DAWN THOMPSON MS, CCC-SLP
Provider Business Mailing Address
First Line : 3030 S JONES BLVD STE 105
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6793
Country : US
Telephone Number : 702-360-1137
Fax Number : 702-341-1511
Provider Business Practice Location Address
First Line : 3030 S JONES BLVD STE 105
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6793
Country : US
Telephone Number : 702-360-1137
Fax Number : 702-341-1511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2009
Last Update Date : 04/29/2011

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Directions to “ MISS KIMBERLY DAWN THOMPSON MS, CCC-SLP” Practice Location

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