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General NPI Number Information
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NPI Number | 1487864625
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Entity Type | Organization
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Legal Business Name | ASSOCIATED THERAPEUTICS, LLC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3306 CLAYS MILL RD STE. 101
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City | LEXINGTON
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State | KY
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Zip | 40503-3482
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Country | US
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Telephone | 859-219-0127
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Fax | 859-219-1602
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Provider Business Mailing Address
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Address Line | 3306 CLAYS MILL RD STE. 101
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City | LEXINGTON
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State | KY
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Zip | 40503-3482
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Country | US
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Telephone | 859-219-0127
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Fax | 859-219-1602
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY HUDSON
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Credential | M.A., CCC
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Telephone | 859-219-0127
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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 | 1962
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License Number State | KY
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