Provider Demographics
NPI:1114171279
Name:GUCHE, KIMBERLEY P (SLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:P
Last Name:GUCHE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KIMBERLEY
Other - Middle Name:A
Other - Last Name:PARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:860 HARD RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8825
Mailing Address - Country:US
Mailing Address - Phone:585-347-1664
Mailing Address - Fax:585-347-1234
Practice Address - Street 1:860 HARD RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-8825
Practice Address - Country:US
Practice Address - Phone:585-347-1664
Practice Address - Fax:585-347-1234
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist