Individual
KIMBERLY AMICK VANDUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1915 HOLLY ST, NASHVILLE, TN 37206
(540) 230-2246
Mailing address
1915 HOLLY ST, NASHVILLE, TN 37206-1924
(540) 230-2246
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1203011
NC
235Z00000X
Speech-Language Pathologist
Primary
4755
TN
Other
Enumeration date
06/30/2011
Last updated
07/09/2018
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