Individual
KIMBERLY MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7719 W 11TH ST N, WICHITA, KS 67212-3006
(316) 655-1636
Mailing address
7719 W 11TH ST N, WICHITA, KS 67212-3006
(316) 773-3533
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
KS
235Z00000X
Speech-Language Pathologist
Primary
2485
KS
Other
Enumeration date
06/01/2007
Last updated
01/22/2026
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