Individual
ABBEY KENNEDY MACMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
14015 HICKORY RIDGE RD, LOUISVILLE, KY 40245-5176
(502) 930-5425
Mailing address
14015 HICKORY RIDGE RD, LOUISVILLE, KY 40245-5176
(502) 930-5425
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
264183
KY
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264183
STATE LICENSE NUMBER
KY
Enumeration date
06/19/2020
Last updated
06/19/2020
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