Provider Demographics
NPI:1386767150
Name:COMBS, KIMBERLY ANN (AUD DOCTOR OF AUDIOL)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:COMBS
Suffix:
Gender:F
Credentials:AUD DOCTOR OF AUDIOL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 TYLERSVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1593
Mailing Address - Country:US
Mailing Address - Phone:513-701-9322
Mailing Address - Fax:513-701-9324
Practice Address - Street 1:6900 TYLERSVILLE RD STE B
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1593
Practice Address - Country:US
Practice Address - Phone:513-701-9322
Practice Address - Fax:513-701-9324
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA0901231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000878155OtherANTHEM