Individual
KIM HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA/SLP,CCC
Contact information
Practice address
440 EASTLAND DR, LEBANON, KY 40033-1967
(270) 402-2379
Mailing address
440 EASTLAND DR, LEBANON, KY 40033-1967
(270) 402-2379
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
342553
KY
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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