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General NPI Number Information
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NPI Number | 1194875328
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Entity Type | Individual
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Provider Name | ELIZABETH M KITCHEN MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 111 BONNIE LN
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City | LOUISVILLE
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State | KY
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Zip | 40218-3207
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Country | US
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Telephone | 502-671-1787
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Fax |
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Provider Business Mailing Address
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Address Line | 504 CROYDON CT
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City | LOUISVILLE
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State | KY
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Zip | 40222-5551
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Country | US
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Telephone | 502-931-0678
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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 | KY-3098
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License Number State | KY
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