Provider Demographics
NPI:1972008324
Name:WEBB, KIERA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIERA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 STAGECOACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230
Mailing Address - Country:US
Mailing Address - Phone:908-783-7310
Mailing Address - Fax:
Practice Address - Street 1:1457 STAGECOACH RD
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:NJ
Practice Address - Zip Code:08230
Practice Address - Country:US
Practice Address - Phone:908-783-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00751900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty