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NPI Code Detail

MEDICARE: KIMBERLY DAWN FREEMAN

MEDICARE: KIMBERLY DAWN FREEMAN
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 Pathologist2011016422MO

General Provider Information

NPI Number : 1174810220
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY DAWN FREEMAN
Provider Business Mailing Address
First Line : 423 W PINE ST
Second Line :
City : HOUSTON
State : MO
Zip : 65483-1147
Country : US
Telephone Number : 417-967-3024
Fax Number :
Provider Business Practice Location Address
First Line : 423 W PINE ST
Second Line :
City : HOUSTON
State : MO
Zip : 65483-1147
Country : US
Telephone Number : 417-967-3024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2011
Last Update Date : 07/08/2011

Similar Medicare Providers

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Practice Location Address:
423 W PINE ST
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Practice Phone: 417-967-3024
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1275662488 — MRS. DARA JACKSON
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1144359365 — MRS. MARY L GLOVER
Practice Location Address:
423 W PINE ST
HOUSTON, MO
65483-1147
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1023298890 — MR. PAUL MORRIS
Practice Location Address:
423 W PINE ST
HOUSTON, MO
65483-1147
Practice Phone: 417-967-3196
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1487101291 — TYANN NETTLETON M.S SLP-CCC
Practice Location Address:
423 W PINE ST
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65483-1147
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Practice Fax: 417-967-2923

Directions to “ KIMBERLY DAWN FREEMAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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