Provider Demographics
NPI:1093908758
Name:WEST, KIMBERLY D (ST)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:WEST
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HCR-1, BOX 130
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746
Mailing Address - Country:US
Mailing Address - Phone:520-822-9201
Mailing Address - Fax:520-822-9202
Practice Address - Street 1:16350 W AJO HWY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85735-2126
Practice Address - Country:US
Practice Address - Phone:520-822-9201
Practice Address - Fax:520-822-9202
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant