Provider Demographics
NPI:1033375266
Name:WARNER, KIMBERLEY MEYER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:MEYER
Last Name:WARNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7158 WYNNRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-2588
Mailing Address - Country:US
Mailing Address - Phone:251-634-4974
Mailing Address - Fax:
Practice Address - Street 1:7158 WYNNRIDGE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-2588
Practice Address - Country:US
Practice Address - Phone:251-634-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1825235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist