Organization
SPEECH-LANGUAGE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN RAE WATERS MA CCC-SLP (OWNER)
(859) 572-0430
Entity
Organization
Contact information
Practice address
3699 ALEXANDRIA PIKE, SUITE D, COLD SPRING, KY 41076-1789
(859) 572-0430
(859) 572-0163
Mailing address
3699 ALEXANDRIA PIKE, SUITE D, COLD SPRING, KY 41076-1789
(859) 572-0430
(859) 572-0163
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/28/2007
Last updated
06/19/2019
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