Individual
KIMBERLY IVETTE KUILAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
1801 S 23RD ST STE 2, FORT PIERCE, FL 34950-4830
(772) 464-3303
Mailing address
1503 SE WALTON LAKES DR, PORT SAINT LUCIE, FL 34952-5106
(787) 454-1029
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
4206
FL
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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