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NPI Code Detail

MEDICARE: KIMBERLY KAYE GORLAND MCD CCC SLP

MEDICARE: KIMBERLY KAYE GORLAND MCD 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 Pathologist2901AL

General Provider Information

NPI Number : 1851526883
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY KAYE GORLAND MCD CCC SLP
Provider Business Mailing Address
First Line : 100 WESTSIDE DR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1908
Country : US
Telephone Number : 334-793-2237
Fax Number : 334-712-6256
Provider Business Practice Location Address
First Line : 100 WESTSIDE DR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1908
Country : US
Telephone Number : 334-793-2237
Fax Number : 334-712-6256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2009
Last Update Date : 02/27/2019

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Directions to “ KIMBERLY KAYE GORLAND MCD CCC SLP” Practice Location

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