Individual
KIM DEMESMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3265 BIDDLE RD, MEDFORD, OR 97504-4122
(813) 653-1149
(813) 654-6644
Mailing address
3265 BIDDLE RD, MEDFORD, OR 97504-4122
(541) 414-6736
(541) 787-4011
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
105211
TX
235Z00000X
Speech-Language Pathologist
Primary
SA11923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007228900
—
FL
05
—
014323100
—
FL
Enumeration date
08/05/2009
Last updated
05/13/2020
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