Provider Demographics
NPI:1689948390
Name:HOWLAND, MARY KIMBERLY (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KIMBERLY
Last Name:HOWLAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:KIMBERLY
Other - Last Name:POPOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3815 E MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2488
Mailing Address - Country:US
Mailing Address - Phone:630-584-7530
Mailing Address - Fax:630-584-7762
Practice Address - Street 1:3815 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2488
Practice Address - Country:US
Practice Address - Phone:630-584-7530
Practice Address - Fax:630-584-7762
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146003707235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist