Kelly, Kimberly L
Kelly, Kimberly L is an individual health care provider with primary practice located at 1116 Alice Dr Ste F , Sumter SC 29150-1941. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Kelly, Kimberly L can be contacted via phone (803) 469-7770.Contact Information
Primary practice address
1116 Alice Dr Ste F
Sumter SC 29150-1941
Phone: (803) 469-7770
Fax: (803) 469-7701
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 2083 | South Carolina |
Profile Details
| NPI number | 1093903197 |
|---|---|
| LBN Legal business name | Kelly, Kimberly L |
| Credentials | M.AUD. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 15th, 2007 |
| Last updated | Oct 15th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093903197 | NPPES |
| South Carolina | MEDICAID | SA0179 |
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