MEDICARE: DR. AILEEN J BANKEMPER PH.D.

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
1	103T00000X	Psychologist	1127	KY

General Provider Information

NPI Number	:	1700918794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AILEEN J BANKEMPER PH.D.

Provider Business Mailing Address
First Line	:	2500 AMSTERDAM RD
Second Line	:
City	:	VILLA HILLS
State	:	KY
Zip	:	41017-5316
Country	:	US
Telephone Number	:	859-331-5471
Fax Number	:	859-331-2136

Provider Business Practice Location Address
First Line	:	2500 AMSTERDAM RD
Second Line	:
City	:	VILLA HILLS
State	:	KY
Zip	:	41017-5316
Country	:	US
Telephone Number	:	859-331-5471
Fax Number	:	859-331-2136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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