Healthcare Provider Details

I. General information

NPI: 1316706807
Provider Name (Legal Business Name): GIGGLES & GAB SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 MAIN STREET
SOUTH SHORE KY
41175-7525
US

IV. Provider business mailing address

496 MAIN STREET
SOUTH SHORE KY
41175
US

V. Phone/Fax

Practice location:
  • Phone: 606-498-4042
  • Fax: 606-498-4057
Mailing address:
  • Phone: 606-498-4042
  • Fax: 606-498-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA JACO
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MA, CCC-SLP
Phone: 606-465-9208