Individual
BRENDA MACMILLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 HERR LN STE 205, LOUISVILLE, KY 40222-4384
(502) 419-7811
Mailing address
1311 HERR LN STE 205, LOUISVILLE, KY 40222-4384
(502) 419-7811
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
138438
KY
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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