Provider Demographics
NPI:1063906592
Name:TIMMERMANN, KARA MARIE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:TIMMERMANN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-3217
Mailing Address - Country:US
Mailing Address - Phone:618-334-7494
Mailing Address - Fax:
Practice Address - Street 1:502 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:IL
Practice Address - Zip Code:62012-1042
Practice Address - Country:US
Practice Address - Phone:618-372-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist