Individual
MARY JO SCANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4501 LOUISE UNDERWOOD WAY, LOUISVILLE, KY 40216-3987
(502) 368-2348
Mailing address
9218 ARTIS WAY, LOUISVILLE, KY 40291-6718
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
23404
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100445890
—
KY
Enumeration date
01/05/2016
Last updated
04/10/2018
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