Provider Demographics
NPI:1467691840
Name:SAUL, KIMBERLY JANICE
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JANICE
Last Name:SAUL
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 1:3776 S 2700 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-3570
Mailing Address - Country:US
Mailing Address - Phone:801-278-6004
Mailing Address - Fax:
Practice Address - Street 1:3776 S 2700 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-3570
Practice Address - Country:US
Practice Address - Phone:801-278-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC002201235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC002201OtherAGBELL ACADEMY