Organization
COMMONWEALTH OF KENTUCKY
Active
Other names
Lee Specialty Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TANYIKA R WAN RHIT (CAO)
(502) 368-2348
Entity
Organization
Contact information
Practice address
4501 LOUISE UNDERWOOD WAY, LOUISVILLE, KY 40216-3987
(502) 368-2348
(502) 371-9067
Mailing address
4501 LOUISE UNDERWOOD WAY, LOUISVILLE, KY 40216-3987
(502) 368-2348
(502) 371-9067
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPINP00225532
KY
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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