Provider Demographics
NPI:1386745875
Name:WATSON CHANDLER, KIMBERLY JOY (AUD)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JOY
Last Name:WATSON CHANDLER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6 COURTSIDE PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-5676
Mailing Address - Country:US
Mailing Address - Phone:501-257-1412
Mailing Address - Fax:501-257-1086
Practice Address - Street 1:2200 FORT ROOTS DRIVE
Practice Address - Street 2:126-NLR
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114
Practice Address - Country:US
Practice Address - Phone:501-257-1412
Practice Address - Fax:501-257-1086
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#235231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist