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General NPI Number Information
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NPI Number | 1891950200
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Entity Type | Organization
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Legal Business Name | KIMBERLY TAYLOR, INC
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 1844 PALOMINO DR
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City | GREENWOOD
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State | AR
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Zip | 72936-4974
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Country | US
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Telephone | 479-629-6578
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Fax |
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Provider Business Mailing Address
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Address Line | 1844 PALOMINO DR
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City | GREENWOOD
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State | AR
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Zip | 72936-4974
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Country | US
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Telephone | 479-629-6578
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST/PRESIDENT
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Name | KIMBERLY DAWN TAYLOR
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Credential | M.S., CCC/SLP
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Telephone | 479-629-6578
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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 | 1443
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License Number State | AR
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