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NPI Code Detail

MEDICARE: MINDI PHILLIPS M.A., CCC-SLP

MEDICARE:   MINDI  PHILLIPS  M.A., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 8902FL
2235Z00000XSpeech-Language Pathologist140964KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104914126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINDI PHILLIPS M.A., CCC-SLP
Provider Business Mailing Address
First Line : 90 HOWARD DR
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-8138
Country : US
Telephone Number : 502-633-1007
Fax Number : 502-437-0624
Provider Business Practice Location Address
First Line : 90 HOWARD DR
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-8138
Country : US
Telephone Number : 502-633-1007
Fax Number : 502-437-0624
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 04/09/2019

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Directions to “ MINDI PHILLIPS M.A., CCC-SLP” Practice Location

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