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Individual

KATHERINE GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC SLP

Contact information

Practice address
320 N LORETTO RD, LEBANON, KY 40033-1300
(270) 699-5788
Mailing address
320 N LORETTO RD, LEBANON, KY 40033-1300
(270) 699-5788

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0640
KY LICENSE
KY
Enumeration date
02/18/2016
Last updated
02/22/2016
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