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General NPI Number Information
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NPI Number | 1639902208
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Entity Type | Organization
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Legal Business Name | KS SPEECH VOICE AND SWALLOWING THERAPY LLC
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1025 BARRINGTON RDG
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City | RICHMOND
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State | IN
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Zip | 47374-7189
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Country | US
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Telephone | 937-583-1833
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 BARRINGTON RDG
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City | RICHMOND
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State | IN
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Zip | 47374-7189
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Country | US
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Telephone | 937-248-8810
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | KIMBERLY SIMMONS
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Credential | MS, CCC/SLP
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Telephone | 937-583-1833
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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 |
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License Number State |
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