Organization
BLUEGRASS KIDS THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATLYN SHAW MS, CCC-SLP (OWNER)
(270) 452-2835
Entity
Organization
Contact information
Practice address
23 W CENTER ST, MADISONVILLE, KY 42431-1941
(270) 452-2835
Mailing address
23 W CENTER ST, MADISONVILLE, KY 42431-1941
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/12/2021
Last updated
10/18/2022
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