# NPI 1598198681

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- **Entity:** Individual
- **Status:** Inactive

## Provider details

- **NPI number:** 1598198681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | 1070 | KY | — |
| 235Z00000X | Speech-Language Pathologist | 15064 | OR | Yes |
| 235Z00000X | Speech-Language Pathologist | SL011501 | PA | — |

## Other

- **Enumeration date:** —
- **Last updated:** —

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1070 | KENTUCKY LICENSE NUMBER | KY |
| 01 | — | 15064 | OREGON LICENSE | OR |
| 01 | — | SL011501 | PA LICENSE | PA |