Provider Demographics
NPI:1689891707
Name:LLOYD, KIMBERLY
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:LLOYD
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 1:1419 W IRIS DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-7830
Mailing Address - Country:US
Mailing Address - Phone:480-861-2181
Mailing Address - Fax:
Practice Address - Street 1:952 E BASELINE RD
Practice Address - Street 2:SUITE A106
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6627
Practice Address - Country:US
Practice Address - Phone:480-926-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP2008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist