Provider Demographics
NPI:1205874617
Name:STREMMEL, KIMBERLY E (CCC-A, AUD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:STREMMEL
Suffix:
Gender:F
Credentials:CCC-A, AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CHESHIRE LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3706
Mailing Address - Country:US
Mailing Address - Phone:888-333-9152
Mailing Address - Fax:763-268-4240
Practice Address - Street 1:1776 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4628
Practice Address - Country:US
Practice Address - Phone:717-845-6903
Practice Address - Fax:717-845-1355
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT005985231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ67176Medicare UPIN
PA099918U7KMedicare ID - Type UnspecifiedIND PROV ID NUMBER