Healthcare Provider Details

I. General information

NPI: 1811873854
Provider Name (Legal Business Name): JENNIFER FILOTTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 MEETING ST APT 4204
LEXINGTON KY
40509-4646
US

IV. Provider business mailing address

2151 MEETING ST APT 4204
LEXINGTON KY
40509-4646
US

V. Phone/Fax

Practice location:
  • Phone: 815-383-7617
  • Fax:
Mailing address:
  • Phone: 815-383-7617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number301184
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: