Organization
MY TURN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A KENNEDY SLP (OWNER/SPEECH LANGUAGE PATHOLOGIST)
(502) 295-6034
Entity
Organization
Contact information
Practice address
1801 ALFRESCO PL, LOUISVILLE, KY 40205-1807
(502) 295-6034
(502) 459-4362
Mailing address
1801 ALFRESCO PL, LOUISVILLE, KY 40205-1807
(502) 295-6034
(502) 459-4362
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2167
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100310040
—
KY
Enumeration date
04/14/2016
Last updated
04/14/2016
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