Individual
MRS. KIMPER CANNON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2017 LYNDHURST AVE, CHARLOTTE, NC 28203-5313
(704) 609-8255
(704) 371-7385
Mailing address
754 IDEAL WAY, CHARLOTTE, NC 28203-5627
(704) 343-0202
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8370
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0639
—
SC
Enumeration date
07/26/2006
Last updated
03/25/2009
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