Provider Demographics
NPI:1407832678
Name:COLEMAN, KIMBERLY RENAE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RENAE
Last Name:COLEMAN
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:1662 DEBRA DR.
Mailing Address - Street 2:COLEMAN SPEECH & LANGUAGE SERVICES, LLC
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703
Mailing Address - Country:US
Mailing Address - Phone:662-347-0830
Mailing Address - Fax:662-537-7887
Practice Address - Street 1:1662 DEBRA DR.
Practice Address - Street 2:COLEMAN SPEECH & LANGUAGE SERVICES, LLC
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703
Practice Address - Country:US
Practice Address - Phone:662-347-0830
Practice Address - Fax:662-537-7887
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSS2900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist