Pettis, Kimberly

Pettis, Kimberly is an individual health care provider with primary practice located at 200 Belle Terre Rd , Port Jefferson NY 11777-1928. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Pettis, Kimberly can be contacted via phone (631) 474-6263.

Contact Information

Primary practice address
200 Belle Terre Rd Port Jefferson NY 11777-1928
Phone: (631) 474-6263
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 012235-1 New York

Profile Details

NPI number 1689739914
LBN Legal business name Pettis, Kimberly
Credentials M.S.CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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