Individual
MRS. KIMBERLY RAE BARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
500 S. GRANT AVENUE, OMRO, WI 54963
(920) 685-2755
Mailing address
500 S. GRANT AVENUE, OMRO, WI 54963
(920) 685-2755
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2715-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42574200
—
WI
Enumeration date
05/07/2007
Last updated
02/08/2010
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