| NPI | 1659777258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA MATTINGLY Member 502-552-4598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 1168) |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2014-11-08 |