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General NPI Number Information
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NPI Number | 1770702151
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Entity Type | Organization
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Legal Business Name | KIMBERLY A. EGBERTS & ASSOC.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 30 FOREST FALLS DR SUITE #1
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City | YARMOUTH
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State | ME
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Zip | 04096-6983
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Country | US
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Telephone | 207-829-4763
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Fax | 207-829-4763
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Provider Business Mailing Address
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Address Line | 74 ROCK RIDGE RUN
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City | CUMBERLAND CENTER
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State | ME
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Zip | 04021-3730
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Country | US
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Telephone | 207-829-4763
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Fax | 207-829-4763
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KIMBERLY ANN EGBERTS
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Credential | MS CCC-SLP
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Telephone | 207-653-8263
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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 | SP518
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License Number State | ME
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