Individual
KIMBERLY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
419 E BROAD ST, COOKEVILLE, TN 38501-3339
(931) 854-5056
Mailing address
419 E BROAD ST, COOKEVILLE, TN 38501-3339
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7002
TN
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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