Individual
KIMBERLY KASER IVERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
7701 E 21ST ST, INDIANAPOLIS, IN 46219-2406
(317) 375-2700
Mailing address
7701 E 21ST ST, INDIANAPOLIS, IN 46219-2406
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003936A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200674380
—
IN
Enumeration date
05/11/2007
Last updated
10/03/2014
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