Commonwealth of Kentucky
NPI #1699124594 in Louisville, Kentucky
Provider Information
- NPI Number
- 1699124594
- Entity Type
- Organization
- Organization Name
- Commonwealth of Kentucky
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Jun 10, 2016
- Last Updated
- Jun 10, 2016
Practice Location
- Address
- 4501 LOUISE UNDERWOOD WAY
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40216-3987
- Phone
- (502) 368-2348
Authorized Official
- Name
- TANYIKA R WAN, RHIT
- Title
- CAO
- Phone
- (502) 368-2348
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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