Individual
KIMBERLY K HAVERKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15955 NEW HALLS FERRY RD, FLORISSANT, MO 63031-1227
(314) 953-4991
Mailing address
15955 NEW HALLS FERRY RD, FLORISSANT, MO 63031-1227
(314) 953-4991
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465926400
—
MO
Enumeration date
07/23/2018
Last updated
07/23/2018
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