MEDICARE: KIMBERLY WARD M.S.

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	101793	TX

General Provider Information

NPI Number	:	1477817781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY WARD M.S.

Provider Business Mailing Address
First Line	:	6733 CLEAR SPRING DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3750
Country	:	US
Telephone Number	:	817-300-1920
Fax Number	:

Provider Business Practice Location Address
First Line	:	6733 CLEAR SPRING DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3750
Country	:	US
Telephone Number	:	817-300-1920
Fax Number	:

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

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	07/02/2012

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Directions to “ KIMBERLY WARD M.S.” Practice Location

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