MEDICARE: KIMBERLY A BRANCACCIO 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
1	235Z00000X	Speech-Language Pathologist	9851	NC

General Provider Information

NPI Number	:	1457470353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A BRANCACCIO M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	20 CRICKETWOOD LN
Second Line	:
City	:	YOUNGSVILLE
State	:	NC
Zip	:	27596-7039
Country	:	US
Telephone Number	:	919-916-9945
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 CRICKETWOOD LN
Second Line	:
City	:	YOUNGSVILLE
State	:	NC
Zip	:	27596-7039
Country	:	US
Telephone Number	:	919-916-9945
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	02/05/2026

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Directions to “ KIMBERLY A BRANCACCIO M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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