Provider Demographics
NPI:1679467633
Name:DUTILL, KIMBERLY JEAN
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JEAN
Last Name:DUTILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 8TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1354
Mailing Address - Country:US
Mailing Address - Phone:484-842-4460
Mailing Address - Fax:
Practice Address - Street 1:901 E 8TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1354
Practice Address - Country:US
Practice Address - Phone:484-842-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist