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General NPI Number Information
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NPI Number | 1710307152
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Entity Type | Organization
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Legal Business Name | THE KID SPOT CENTER
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 529 WESTPORT RD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2949
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Country | US
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Telephone | 270-763-8225
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 RIVER SHORE DR APT 122
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City | LOUISVILLE
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State | KY
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Zip | 40206-2770
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JENNIFER HOUK
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Credential |
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Telephone | 812-763-8225
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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 | 235Z00000X
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License Number State | KY
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