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General NPI Number Information
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NPI Number | 1497924435
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Entity Type | Individual
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Provider Name | KIMBERLY ANN POLLOCK MSCCCSLP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 1350 OLD FREEPORT RD SUITE 2AR
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City | PITTSBURGH
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State | PA
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Zip | 15238-3122
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Country | US
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Telephone | 412-760-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 1470 MCFARLAND RD
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City | PITTSBURGH
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State | PA
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Zip | 15216-2344
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Country | US
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Telephone | 412-563-4165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLOO5967L
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License Number State | PA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 123456
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 123456
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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