Provider Demographics
NPI:1265621262
Name:SINCLAIR, KIMBERLY PAYNE (AUD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:PAYNE
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6204 BRIDGEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-9216
Mailing Address - Country:US
Mailing Address - Phone:517-974-7797
Mailing Address - Fax:517-253-8429
Practice Address - Street 1:6204 BRIDGEWATER CIR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-974-7797
Practice Address - Fax:517-253-8429
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000473231H00000X
TX80135231H00000X
FLAY1710231H00000X
AZDA9985231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist