Provider Demographics
NPI:1639902208
Name:KS SPEECH VOICE AND SWALLOWING THERAPY LLC
Entity type:Organization
Organization Name:KS SPEECH VOICE AND SWALLOWING THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:937-583-1833
Mailing Address - Street 1:1025 BARRINGTON RDG
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-7189
Mailing Address - Country:US
Mailing Address - Phone:937-248-8810
Mailing Address - Fax:
Practice Address - Street 1:1025 BARRINGTON RDG
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-7189
Practice Address - Country:US
Practice Address - Phone:937-583-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty