Provider Demographics
NPI:1609116086
Name:FLOWERS, KIMBERLEY WEAVER
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:WEAVER
Last Name:FLOWERS
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 1:521 WINTERBERRY TRL
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7837
Mailing Address - Country:US
Mailing Address - Phone:828-963-2460
Mailing Address - Fax:
Practice Address - Street 1:521 WINTERBERRY TRL
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7837
Practice Address - Country:US
Practice Address - Phone:828-963-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist