Provider Demographics
NPI:1487042065
Name:REDFORD, KIMBERLY CHESNEY (AUD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CHESNEY
Last Name:REDFORD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E RIVERSIDE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8720
Mailing Address - Country:US
Mailing Address - Phone:435-688-8866
Mailing Address - Fax:435-688-2882
Practice Address - Street 1:164 E 5900 S STE A107
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7361
Practice Address - Country:US
Practice Address - Phone:801-843-6113
Practice Address - Fax:801-843-6114
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9167775-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist