Individual
KIMBERLY JEANINE JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
11 N 400 W, LAPORTE, IN 46350-7908
(219) 324-7955
Mailing address
3268 S 28TH ST, KALAMAZOO, MI 49048-8619
(219) 608-4423
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002444A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200198700
—
IN
01
—
200718440A
FIRST STEPS PROVIDER #
IN
Enumeration date
05/17/2006
Last updated
07/16/2019
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