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NPI Code Detail

MEDICARE: MRS. KYMBERLY HENSLEY TUCKFIELD MSP

MEDICARE: MRS. KYMBERLY HENSLEY TUCKFIELD MSP
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 Pathologist12973OR
2235Z00000XSpeech-Language Pathologist5249SC

General Provider Information

NPI Number : 1255638987
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KYMBERLY HENSLEY TUCKFIELD MSP
Provider Business Mailing Address
First Line : 355 CEDAR SPRINGS RD
Second Line :
City : SPARTANBURG
State : SC
Zip : 29302-4628
Country : US
Telephone Number : 971-678-9822
Fax Number :
Provider Business Practice Location Address
First Line : 355 CEDAR SPRINGS RD
Second Line :
City : SPARTANBURG
State : SC
Zip : 29302-4628
Country : US
Telephone Number : 971-678-9822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2011
Last Update Date : 08/14/2013

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Directions to “ MRS. KYMBERLY HENSLEY TUCKFIELD MSP” Practice Location

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