Provider Demographics
NPI:1285185975
Name:BRAUER, KIMBERLY A (AUD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:BRAUER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4438
Mailing Address - Country:US
Mailing Address - Phone:801-373-7438
Mailing Address - Fax:801-373-7486
Practice Address - Street 1:3303 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4438
Practice Address - Country:US
Practice Address - Phone:801-373-7438
Practice Address - Fax:013-737-4868
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016032994231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist