Individual
MRS. KIMBERLY MARIE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 W GERONIMO ST, CHANDLER, AZ 85224-5616
(480) 782-0572
Mailing address
1625 WEST GERONIMO STREET, CHANDLER, AZ 85224
(480) 782-0572
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL5190
AZ
Other
Enumeration date
11/22/2006
Last updated
07/08/2007
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