Individual
KIMBERLY WINTER PANTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
7107 28TH AVE NW, SEATTLE, WA 98117-5946
(513) 652-1526
Mailing address
7107 28TH AVE NW, SEATTLE, WA 98117-5946
(513) 652-1526
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14090567
—
235Z00000X
Speech-Language Pathologist
22006157A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14090567
ASHA
—
01
—
22006157A
STATE OF INDIANA
IN
Enumeration date
01/19/2021
Last updated
01/19/2021
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