Provider Demographics
NPI:1013942671
Name:SCARBORO, KIM SCHIRRMAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:SCHIRRMAN
Last Name:SCARBORO
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 1:21 WILBROOK DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-9633
Mailing Address - Country:US
Mailing Address - Phone:336-688-1643
Mailing Address - Fax:336-476-7130
Practice Address - Street 1:21 WILBROOK DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-9633
Practice Address - Country:US
Practice Address - Phone:336-688-1643
Practice Address - Fax:336-476-7130
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76629OtherSLP
NC7210879Medicaid