Provider Demographics
NPI:1316227630
Name:TAYLOR, KIMBERLY ANN (MS, CCC- SLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, CCC- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4269 APACHE PLUME DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7637
Mailing Address - Country:US
Mailing Address - Phone:719-233-1743
Mailing Address - Fax:719-465-1966
Practice Address - Street 1:4269 APACHE PLUME DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7637
Practice Address - Country:US
Practice Address - Phone:719-233-1743
Practice Address - Fax:719-465-1966
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist