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General NPI Number Information
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NPI Number | 1861121394
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Entity Type | Organization
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Legal Business Name | KRISTY STITH THERAPY
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 525 LANGLEY TRCE
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-6742
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Country | US
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Telephone | 270-872-7974
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Fax |
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Provider Business Mailing Address
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Address Line | 525 LANGLEY TRCE
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-6742
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Country | US
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Telephone | 270-872-7974
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Fax |
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Authorized Official
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Title or Position | DI
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Name | MRS. KRISTY C STITH
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Credential |
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Telephone | 270-872-7974
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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 |
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License Number State |
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