Provider Demographics
NPI:1073730461
Name:TAPPLY, KIMBERLY (CFSLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:TAPPLY
Suffix:
Gender:F
Credentials:CFSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 KEYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1904
Mailing Address - Country:US
Mailing Address - Phone:978-537-9327
Mailing Address - Fax:
Practice Address - Street 1:86 DREPANOS ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-2361
Practice Address - Country:US
Practice Address - Phone:978-343-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PENDING235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist