MEDICARE: KIMBERLY THOMAS MS 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
1	235Z00000X	Speech-Language Pathologist	SL002881L	PA

General Provider Information

NPI Number	:	1447582473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY THOMAS MS CCC/SLP

Provider Business Mailing Address
First Line	:	233 HAWTHORN ST
Second Line	:
City	:	NEW HOLLAND
State	:	PA
Zip	:	17557-1835
Country	:	US
Telephone Number	:	717-951-0822
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 W MAIN ST STE 2
Second Line	:
City	:	NEW HOLLAND
State	:	PA
Zip	:	17557-1144
Country	:	US
Telephone Number	:	717-951-0822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	02/01/2010

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Directions to “ KIMBERLY THOMAS MS CCC/SLP” Practice Location

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