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General NPI Number Information
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NPI Number | 1134579386
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Entity Type | Organization
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Legal Business Name | TRISHA T. BERNARD, SLP, CCC-SLP, PLLC
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 120 KENTUCKY AVE SUITE 20
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City | LEXINGTON
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State | KY
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Zip | 40502-1899
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Country | US
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Telephone | 859-420-3613
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Fax | 855-476-5682
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Provider Business Mailing Address
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Address Line | 120 KENTUCKY AVE SUITE 20
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City | LEXINGTON
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State | KY
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Zip | 40502-1899
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Country | US
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Telephone | 859-420-3613
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Fax | 855-476-5682
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | TRISHA T BERNARD
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Credential | MS, CCC-SLP
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Telephone | 859-420-3613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 142670
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License Number State | KY
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