=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730236829
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON BROOKE KAYS M.S., CF, SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3427 US ROUTE 60 EAST
-----------------------------------------------------
City | BARBOURSVILLE
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-736-8255
-----------------------------------------------------
Fax | 304-736-4851
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1628 UPLAND RD
-----------------------------------------------------
City | HUNTINGTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25701-4143
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-638-1079
-----------------------------------------------------
Fax | 304-736-4851
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | PSLP-0372
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------