Provider Demographics
NPI:1609933779
Name:PAJOR-PERRIN, KIMBERLY (MS CCC SP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:PAJOR-PERRIN
Suffix:
Gender:F
Credentials:MS CCC SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:ME
Mailing Address - Zip Code:04055-5039
Mailing Address - Country:US
Mailing Address - Phone:207-402-1130
Mailing Address - Fax:
Practice Address - Street 1:81 MADISON DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:ME
Practice Address - Zip Code:04055-5039
Practice Address - Country:US
Practice Address - Phone:207-402-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1705235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM13205579Medicaid