Individual
MS. DONNA M VESTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 TRAIN STATION WAY, LOUISVILLE, KY 40272-4663
(502) 387-8714
Mailing address
7000 TRAIN STATION WAY, LOUISVILLE, KY 40272-4663
(502) 387-8714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
000071985
KY
171M00000X
Case Manager/Care Coordinator
000071985
KY
222Q00000X
Developmental Therapist
Primary
000071985
KY
225A00000X
Music Therapist
YPAS1987
KY
235500000X
Speech/Language/Hearing Specialist/Technologist
000071985
KY
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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