Provider Demographics
NPI:1669008348
Name:GREER, KIMBERLY DAWN
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DAWN
Last Name:GREER
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 1:516 LOWER BEAR WALLOW RD
Mailing Address - Street 2:
Mailing Address - City:DANTE
Mailing Address - State:VA
Mailing Address - Zip Code:24237-7130
Mailing Address - Country:US
Mailing Address - Phone:276-495-7797
Mailing Address - Fax:
Practice Address - Street 1:27018 LEE HWY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7512
Practice Address - Country:US
Practice Address - Phone:276-525-6043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA220200771235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist