Individual
GINA LESLIE KIMMEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
2840 NE 19TH ST, POMPANO BEACH, FL 33062-3109
(954) 943-9589
(954) 943-4115
Mailing address
2840 NE 19TH ST, POMPANO BEACH, FL 33062-3109
(954) 785-8052
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
SA 5518
FL
235Z00000X
Speech-Language Pathologist
Primary
SA5518
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890371900
—
FL
Enumeration date
02/14/2007
Last updated
12/21/2011
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