Individual
KIMBERLY WATTS WIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1829 E FRANKLIN ST STE 600, CHAPEL HILL, NC 27514-5863
(919) 968-3456
Mailing address
213 DUTCHESS DR, CARY, NC 27513-4239
(919) 638-4239
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7734
NC
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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