Individual
KIMBERLY LYNN DUSTO CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
16528 127TH AVENUE CT E, PUYALLUP, WA 98374-9659
(253) 840-8809
Mailing address
16528 127TH AVENUE CT E, PUYALLUP, WA 98374-9659
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61208886
WA
Other
Enumeration date
10/26/2020
Last updated
10/27/2021
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