Individual
AUDREY KINZINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12768 WOOD TRAIL BLVD, TAMPA, FL 33625-5905
(813) 358-7474
Mailing address
12768 WOOD TRAIL BLVD, TAMPA, FL 33625-5905
(813) 358-7474
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
SA19267
FL
235Z00000X
Speech-Language Pathologist
Primary
SZ9567
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107133700
—
FL
Enumeration date
06/30/2020
Last updated
01/08/2022
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