Provider Demographics
NPI:1477534162
Name:JENKINS, KIMBERLY CLIFT (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:CLIFT
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:BETH
Other - Last Name:CLIFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:U.T. HEARING AND SPEECH CENTER
Mailing Address - Street 2:1600 PEYTON MANNING PASS
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-5451
Mailing Address - Fax:865-974-4639
Practice Address - Street 1:455 SOUTH STADIUM HALL
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-1788
Practice Address - Fax:865-974-1539
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist