Individual
MRS. KIMBERLY ANN TANCOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
10915 W 133RD AVE, CEDAR LAKE, IN 46303-9706
(219) 390-7498
(219) 390-7549
Mailing address
1507 WESTCHESTER AVE, CHESTERTON, IN 46304-2852
(219) 241-6482
(219) 390-7549
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IN
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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