Provider Demographics
NPI:1730501768
Name:DI SALVO, KIMBERLY JEAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JEAN
Last Name:DI SALVO
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Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:43 OLD WARD BRIDGE RD
Mailing Address - Street 2:PLYMOUTH ELEMENTARY SCHOOL
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1230
Mailing Address - Country:US
Mailing Address - Phone:603-536-1152
Mailing Address - Fax:603-536-9085
Practice Address - Street 1:43 OLD WARD BRIDGE RD
Practice Address - Street 2:PLYMOUTH ELEMENTARY SCHOOL
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1230
Practice Address - Country:US
Practice Address - Phone:603-536-1152
Practice Address - Fax:603-536-9085
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH1070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist