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NPI Code Detail

MEDICARE: KIMBERLEY COORE-POWELL FOX M.S., CCC-SLP

MEDICARE:   KIMBERLEY  COORE-POWELL FOX  M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA5190FL

Other Identifiers

General Provider Information

NPI Number : 1073691416
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLEY COORE-POWELL FOX M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1103 E JASMINE LANE
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-3952
Country : US
Telephone Number : 954-649-9397
Fax Number : 954-917-9397
Provider Business Practice Location Address
First Line : 1103 E JASMINE LANE
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-3952
Country : US
Telephone Number : 954-649-9397
Fax Number : 954-917-9397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 07/09/2007

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Directions to “ KIMBERLEY COORE-POWELL FOX M.S., CCC-SLP” Practice Location

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