Individual
KIMBERLY CARSON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1805 MOUNT ISLE HARBOR DRIVE, CHARLOTTE, NC 28214-5405
(704) 258-1724
(704) 598-3024
Mailing address
PO BOX 480462, CHARLOTTE, NC 28269-5320
(704) 258-1724
(704) 598-3024
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
4039
SC
235Z00000X
Speech-Language Pathologist
Primary
8790
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-3092660
TAX ID
NC
Enumeration date
06/29/2007
Last updated
06/13/2013
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