Provider Demographics
NPI:1326147802
Name:BARNARD, KYMBERLY (M S, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KYMBERLY
Middle Name:
Last Name:BARNARD
Suffix:
Gender:F
Credentials:M S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 TIMBER RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035
Mailing Address - Country:US
Mailing Address - Phone:618-466-6703
Mailing Address - Fax:618-466-2943
Practice Address - Street 1:6501 TIMBER RIDGE LN
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035
Practice Address - Country:US
Practice Address - Phone:618-466-6703
Practice Address - Fax:618-466-2943
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist