Individual
KIMBERLY DONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
2230 BABAR LN STE 5, FLORENCE, SC 29501-1248
(803) 908-5616
Mailing address
416 SOUTHAMPTON DR, IRMO, SC 29063-9766
(803) 908-5616
(803) 708-5618
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4642
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85-0815778
—
SC
Enumeration date
11/03/2012
Last updated
04/02/2024
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