MEDICARE: MRS. CYNTHIA ELAINE PANK SIMPSON M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	KY-2257	KY

General Provider Information

NPI Number	:	1518051853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA ELAINE PANK SIMPSON M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	7302 DEEP WELL COURT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291
Country	:	US
Telephone Number	:	502-749-4443
Fax Number	:	502-749-6241

Provider Business Practice Location Address
First Line	:	7302 DEEP WELL COURT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291
Country	:	US
Telephone Number	:	502-749-4443
Fax Number	:	502-749-6241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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