Individual
KIMBERLY FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1155 N LAFAYETTE DR, SUMTER, SC 29150-2913
(803) 773-1291
Mailing address
672 MATTISON AVE, SUMTER, SC 29150-3720
(803) 778-6814
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1510
SC
Other
Enumeration date
08/04/2017
Last updated
03/17/2018
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