Individual
MRS. AMY YVONNE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., ED., CCC-SLP
Contact information
Practice address
643 SWEETWATER RD., BEREA, KY 40403
(606) 308-5396
Mailing address
643 SWEETWATER RD., BEREA, KY 40403
(606) 308-5396
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2373
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01862
PROVIDER # FIRST STEPS
KY
Enumeration date
05/31/2007
Last updated
07/08/2007
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