Provider Demographics
NPI:1427835537
Name:KEARNEY, KIMBERLEY ANN (SLP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:ANN
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 LESTER AVE
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1213
Mailing Address - Country:US
Mailing Address - Phone:610-507-1637
Mailing Address - Fax:
Practice Address - Street 1:544 N PENRYN RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-8562
Practice Address - Country:US
Practice Address - Phone:717-665-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty