Kimberly Bagley, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Bartow, FL

NPI 1609250489 · NPPES record last updated Jul 17, 2015

Key facts

NPI
1609250489
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
365 Lyle Pkwy
Bartow, FL 33830-9247
Phone
(863) 397-3315
NPI assigned
Jul 12, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X FL Yes

Addresses

Primary practice location

365 Lyle Pkwy
Bartow, FL 33830-9247

Mailing address

PO Box 1781
Bartow, FL 33831-1781
Phone (321) 961-3489

Other names

  • Kimberly Taczak Bagley Former name

Other providers in Bartow, FL

All providers in Bartow, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.