Healthcare Provider Details

I. General information

NPI: 1407564040
Provider Name (Legal Business Name): FIRST WORDS SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CRUME RD
VINE GROVE KY
40175-1125
US

IV. Provider business mailing address

101 CRUME RD
VINE GROVE KY
40175-1125
US

V. Phone/Fax

Practice location:
  • Phone: 270-352-7061
  • Fax:
Mailing address:
  • Phone: 270-352-7061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMIE SUMMITT
Title or Position: OWNER/SLP
Credential: MS, CCC/SLP
Phone: 270-352-7061