Provider Demographics
NPI:1801203849
Name:MCELROY, KIMBERLEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:
Last Name:MCELROY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1898 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1235
Mailing Address - Country:US
Mailing Address - Phone:910-401-8084
Mailing Address - Fax:
Practice Address - Street 1:1898 RIO VISTA DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-1235
Practice Address - Country:US
Practice Address - Phone:910-401-8084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist