Healthcare Provider Details

I. General information

NPI: 1164757548
Provider Name (Legal Business Name): KIM HUFFMAN-PERRY SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 GUS KAPLAN DR
ALEXANDRIA LA
71301-3376
US

IV. Provider business mailing address

2006 GUS KAPLAN DR
ALEXANDRIA LA
71301-3376
US

V. Phone/Fax

Practice location:
  • Phone: 318-487-5020
  • Fax:
Mailing address:
  • Phone: 318-487-5020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2873
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: