Kimbro, Jackie Doermann
Kimbro, Jackie Doermann is an sole proprietor health care provider with primary practice located at 25958 Melrose Ln , Madison AL 35756-3064. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Kimbro, Jackie Doermann can be contacted via phone (256) 693-5252.Contact Information
Primary practice address
25958 Melrose Ln
Madison AL 35756-3064
Phone: (256) 693-5252
Fax: (855) 692-2414
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 2815 | Alabama |
Profile Details
| NPI number | 1568804268 |
|---|---|
| LBN Legal business name | Kimbro, Jackie Doermann |
| Credentials | CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 23rd, 2013 |
| Last updated | Feb 9th, 2015 - about 11 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 | 1568804268 | NPPES |
| Alabama | MEDICAID | 164512 |
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