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General NPI Number Information
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NPI Number | 1487008561
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Entity Type | Organization
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Legal Business Name | MY TURN
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 1801 ALFRESCO PL
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City | LOUISVILLE
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State | KY
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Zip | 40205-1807
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Country | US
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Telephone | 502-295-6034
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Fax | 502-459-4362
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Provider Business Mailing Address
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Address Line | 1801 ALFRESCO PL
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City | LOUISVILLE
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State | KY
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Zip | 40205-1807
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Country | US
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Telephone | 502-295-6034
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Fax | 502-459-4362
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | MARY A KENNEDY
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Credential | SLP
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Telephone | 502-295-6034
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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 | 2167
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License Number State | KY
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