Organization
CLINICORP SPEECH PATHOLOGY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA LOUISE DIERSING M.S., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(502) 935-8522
Entity
Organization
Contact information
Practice address
7743 SAINT ANDREWS CHURCH RD, SUITE A, LOUISVILLE, KY 40214-3997
(502) 935-8522
(502) 413-5700
Mailing address
7743 SAINT ANDREWS CHURCH RD, SUITE A, LOUISVILLE, KY 40214-3997
(502) 935-8522
(502) 413-5700
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380381
ANTHEM
KY
01
—
000000380382
ANTHEM PROVIDER ID #
KY
Enumeration date
02/12/2007
Last updated
08/22/2020
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