Individual
CONNIE R PIERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
105 WINDSOR PATH, SUITE 3, GEORGETOWN, KY 40324-9617
(859) 588-3709
(502) 603-0622
Mailing address
105 WINDSOR PATH, SUITE 3, GEORGETOWN, KY 40324-9617
(859) 588-3709
(502) 603-0622
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0868
KY
235Z00000X
Speech-Language Pathologist
Primary
142321
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000818511
ANTHEM
KY
05
—
7100270860
—
KY
Enumeration date
05/15/2013
Last updated
03/03/2017
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