Provider Demographics
NPI:1306164959
Name:FREY, KIMBERLY LYNNE (MS)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNNE
Last Name:FREY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13001 E 17TH PL STE F546
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2578
Mailing Address - Country:US
Mailing Address - Phone:303-724-4990
Mailing Address - Fax:303-724-3594
Practice Address - Street 1:13001 E 17TH PL STE F546
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2578
Practice Address - Country:US
Practice Address - Phone:303-724-4990
Practice Address - Fax:303-724-3594
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist