MEDICARE: MS. KIMBERLY ANN OGLETHORPE 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	SA 7847	FL

General Provider Information

NPI Number	:	1467662627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY ANN OGLETHORPE M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	775 SARINA TER SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-4046
Country	:	US
Telephone Number	:	772-713-5283
Fax Number	:

Provider Business Practice Location Address
First Line	:	775 SARINA TER SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-4046
Country	:	US
Telephone Number	:	772-713-5283
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/12/2011

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Directions to “ MS. KIMBERLY ANN OGLETHORPE M.S., CCC-SLP” Practice Location

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