Provider Demographics
NPI:1164934071
Name:TIMMER SPEECH THERAPY SERVICES
Entity Type:Organization
Organization Name:TIMMER SPEECH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:605-574-9593
Mailing Address - Street 1:12728 KENNEDYVILLE LOOP
Mailing Address - Street 2:
Mailing Address - City:HILL CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57745-6605
Mailing Address - Country:US
Mailing Address - Phone:605-574-9593
Mailing Address - Fax:605-574-9593
Practice Address - Street 1:12728 KENNEDYVILLE LOOP
Practice Address - Street 2:
Practice Address - City:HILL CITY
Practice Address - State:SD
Practice Address - Zip Code:57745-6605
Practice Address - Country:US
Practice Address - Phone:605-574-9593
Practice Address - Fax:605-574-9593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty