Provider Demographics
NPI:1356651707
Name:RICE, KIMBERLY MARIE
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MARIE
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S. 25TH ST.
Mailing Address - Street 2:P.O. BOX 503
Mailing Address - City:BETHANY
Mailing Address - State:MO
Mailing Address - Zip Code:64424
Mailing Address - Country:US
Mailing Address - Phone:660-425-7400
Mailing Address - Fax:660-425-7404
Practice Address - Street 1:614 WASHINGTON ST.
Practice Address - Street 2:SUITE 101
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601
Practice Address - Country:US
Practice Address - Phone:660-646-7110
Practice Address - Fax:660-646-7110
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010023610237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist