Individual
KIMBERLY R GOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 INTERSTATE DR, WENTZVILLE, MO 63385-4510
(636) 327-3800
(636) 327-8611
Mailing address
280 INTERSTATE DR, WENTZVILLE, MO 63385-4510
(636) 327-3800
(636) 327-8611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114697
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114697
MO DIVISON OF PROFESSIONAL REGISTRATION
MO
Enumeration date
11/30/2017
Last updated
11/30/2017
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