Healthcare Provider Details

I. General information

NPI: 1215465588
Provider Name (Legal Business Name): JAIME LAMPONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 08/19/2026
Certification Date: 09/28/2020
Deactivation Date: 09/28/2020
Reactivation Date: 08/19/2026

III. Provider practice location address

3600 EVENSONG DR
UNION KY
41091-6906
US

IV. Provider business mailing address

10805 DORAL CT
UNION KY
41091-9226
US

V. Phone/Fax

Practice location:
  • Phone: 859-496-2317
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number168157
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: