Individual
BETHANY COOPER WATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
2412 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 224-4081
(859) 224-4082
Mailing address
2412 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 224-4081
(859) 224-4082
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2425
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100338720
—
KY
Enumeration date
01/08/2007
Last updated
07/17/2020
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