Provider Demographics
NPI:1326584459
Name:JONES, KIMBERLY LORETTA (M A - SLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LORETTA
Last Name:JONES
Suffix:
Gender:F
Credentials:M A - SLP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LORETTA
Other - Last Name:GLENN-HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M A - SLP
Mailing Address - Street 1:600 JEFFERSON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-4900
Mailing Address - Country:US
Mailing Address - Phone:407-617-0447
Mailing Address - Fax:
Practice Address - Street 1:9757 MARKET GREEN PL S APT 325B
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-1172
Practice Address - Country:US
Practice Address - Phone:407-617-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist