Provider Demographics
NPI:1467984542
Name:FRANCIS, KAMILAH (SLP)
Entity Type:Individual
Prefix:
First Name:KAMILAH
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KAMILAH
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 BUXTON FARM ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-212-4191
Mailing Address - Fax:203-212-4191
Practice Address - Street 1:30 BUXTON FARM ROAD
Practice Address - Street 2:SUITE 230
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-212-4191
Practice Address - Fax:203-212-4191
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist