Provider Demographics
NPI:1467801571
Name:DUNCAN, KIMBERLY ANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W 48TH ST APT 17
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1304
Mailing Address - Country:US
Mailing Address - Phone:847-894-5324
Mailing Address - Fax:
Practice Address - Street 1:880 3RD AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4730
Practice Address - Country:US
Practice Address - Phone:212-305-5289
Practice Address - Fax:646-317-2720
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist