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Individual
KIMBERLY ANTUSH
Active
Individual
KIMBERLY ANTUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7411
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
366504
MEDICARE
OH
05
—
7255198
—
OH
Enumeration date
04/29/2009
Last updated
04/29/2009
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