Basic Information
| Provider Information | |||||||||
| NPI: | 1316106487 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEGIN | ||||||||
| FirstName: | KIM | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 TENEYCK ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492012486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172051468 | ||||||||
| FaxNumber: | 5178416917 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 TENEYCK ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | JACKSON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492012461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5177871468 | ||||||||
| FaxNumber: | 5178416917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2008 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 1601000506 | MI | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.