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Individual

ELIZABETH AVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
2625 BARDSTOWN RD, ST CATHARINE, KY 40061-9435
(859) 336-3974
Mailing address
103 LINDEN AVE, BARDSTOWN, KY 40004-6804

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
167266
KY

Other

Enumeration date
05/30/2017
Last updated
05/30/2017
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