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General NPI Number Information
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NPI Number | 1023632171
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Entity Type | Individual
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Provider Name | AMY KEISLER M.ED., CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 9712 WHITE BLOSSOM BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40241-4178
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Country | US
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Telephone | 402-640-2865
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Fax |
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Provider Business Mailing Address
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Address Line | 9712 WHITE BLOSSOM BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40241-4178
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Country | US
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Telephone | 402-640-2865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 140347
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License Number State | KY
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