Organization
EASTERN KENTUCKY SPEECH AND LANGUAGE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA WEBB M.S. CCC/SLP (EXECUTIVE DIRECTOR)
(606) 205-3121
Entity
Organization
Contact information
Practice address
3041 KY RT 7, WAYLAND, KY 41666
(606) 205-3121
(606) 447-2493
Mailing address
PO BOX 183, WAYLAND, KY 41666-0183
(606) 205-3121
(606) 447-2493
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2895
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100280630
—
KY
Enumeration date
07/03/2014
Last updated
07/03/2014
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