Individual
KIMBERLY C RAYBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
302 AUTUMN CREST DR, RIDGELAND, MS 39157-2603
(601) 856-1519
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0722
MS
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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