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Individual

KIMBERLYNN M MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7724
(712) 732-1275
Mailing address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7724
(712) 732-1275

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
002324
IA
235Z00000X
Speech-Language Pathologist
0383470
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665141
IA
Enumeration date
01/20/2012
Last updated
09/10/2013
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