Individual
KIMBERLY JONES MANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1429 E MARION ST, STE. 5, SHELBY, NC 28150-4986
(704) 480-5440
Mailing address
3021 COLONY RIDGE DR, GASTONIA, NC 28056-1602
(704) 865-7958
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4084
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139C6
BLUECROSS BLUESHIELD
NC
Enumeration date
03/29/2007
Last updated
07/08/2007
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