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Organization

FIRST CLASS CHILD CARE PLACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PHOEBE ROSIMO WILLIAMSON M.S.-CCC,SLP (CO-DIRECTOR)
(502) 553-0360
Entity
Organization

Contact information

Practice address
4910 SIMPSON DRIVE, LOUISVILLE, KY 40218
(502) 553-0360
Mailing address
PO BOX 18735, LOUISVILLE, KY 40261-0735
(502) 553-0360

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1921
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1375
PROVIDER NUMBER
KY
Enumeration date
02/22/2007
Last updated
08/22/2020
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