Individual provider · NPI-1

Kimberly Kathlene Booth, M.S., CCC-SLP

Speech-Language Pathologist, · Lutz, FL

NPI number1932200805
StatusActive
Last updated in NPPESSep 3, 2022

Details

NPI
1932200805
Entity type
Individual (NPI-1)
Name
Ms. Kimberly Kathlene Booth
Credential
M.S., CCC-SLP
Sex
Female
Sole proprietor
No
Enumeration date
Sep 25, 2006
Certification date
Sep 3, 2022
Last updated
Sep 3, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,SA3850FLYes

Practice location

16102 N Florida Ave
Lutz, FL 33549-6129

Phone 813-873-1936 · Fax 813-873-8837

Mailing address

16102 N Florida Ave
Lutz, FL 33549-6129

Phone 813-873-1936 · Fax 813-873-8837

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