Healthcare Provider Details

I. General information

NPI: 1891162004
Provider Name (Legal Business Name): KIMBERLEY BATTLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 OLD ALICE RD SUITE 600
BROWNSVILLE TX
78520-8268
US

IV. Provider business mailing address

871 OLD ALICE RD SUITE 600
BROWNSVILLE TX
78520-8268
US

V. Phone/Fax

Practice location:
  • Phone: 956-541-2102
  • Fax: 956-541-2502
Mailing address:
  • Phone: 956-541-2102
  • Fax: 956-541-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number34660
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: