MS. KIMBERLY BANKER JEFFERSON, MA, CCC-SLP - NPI NUMBER 1659527034

Summary

Provider Name: MS. KIMBERLY BANKER JEFFERSON, MA, CCC-SLP

NPI Number: 1659527034

Clasification: Speech-Language Pathologist (235Z00000X)

Address:
2019 GRAND BLVD
NISKAYUNA, NY
ZIP 12309

Phone Number: (518) 372-2037



Detailed Information

MS. Kimberly Banker Jefferson, MA, CCC-SLP is a speech-language pathologist in Niskayuna, NY. The provider is a speech pathologist is a person qualified by a master�s degree in speech-language pathology, and where applicable, licensed by the state and practicing within the scope of the license. Also, known as speech therapist, a speech pathologist evaluates patients with language and speech impairments or disorders, whether arising from physiological and neurological disturbances, defective articulation or foreign dialects, and conducts remedial programs designed to restore or improve their communication efficacy. Speech pathologists assess and treat persons with speech, language, voice, and fluency disorders. The assigned NPI number for this provider is 1659527034 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

2019 GRAND BLVD
NISKAYUNA, NY
ZIP 12309-239
Phone: (518) 372-2037

The enumeration date for this NPI number is 8/17/2008 and was last updated on 8/17/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 235Z00000X Speech-Language Pathologist 012483-1 NY Yes

NPI Record

No. Field Name Field Value
1 NPI 1659527034
2 Entity Type Code 1
3 Provider Last Name Legal Name JEFFERSON
4 Provider First Name KIMBERLY
5 Provider Middle Name BANKER
6 Provider Name Prefix Text MS.
7 Provider Credential Text MA, CCC-SLP
8 Provider First Line Business Practice Location Address 2019 GRAND BLVD
9 Provider Business Practice Location Address City Name NISKAYUNA
10 Provider Business Practice Location Address State Name NY
11 Provider Business Practice Location Address Postal Code 123095239
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 5183722037
14 Provider Enumeration Date 8/17/2008
15 Last Update Date 8/17/2008
16 Provider Gender Code F
17 Healthcare Provider Taxonomy Code 1 235Z00000X
18 Provider License Number 1 012483-1
19 Provider License Number State Code 1 NY
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Sole Proprietor Y

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.