Provider Demographics
NPI:1134352743
Name:HALE, KIMBERLY ELAINE (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ELAINE
Last Name:HALE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:ELAINE
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:3750 OLD STATE ROUTE 56
Mailing Address - Street 2:
Mailing Address - City:NEW MARSHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45766-9763
Mailing Address - Country:US
Mailing Address - Phone:740-591-9041
Mailing Address - Fax:
Practice Address - Street 1:3750 OLD STATE ROUTE 56
Practice Address - Street 2:
Practice Address - City:NEW MARSHFIELD
Practice Address - State:OH
Practice Address - Zip Code:45766-9763
Practice Address - Country:US
Practice Address - Phone:740-591-9041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-29
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.03879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist