Basic Information
| Provider Information | |||||||||
| NPI: | 1194177063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDEY | ||||||||
| FirstName: | KATHRYNE | ||||||||
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| Credential: | CCC SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1024 CLAIBORNE WAY | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405172730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8597713665 | ||||||||
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| Practice Location | |||||||||
| Address1: | 290 ALUMNI DR | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592182322 | ||||||||
| FaxNumber: | 8592570284 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2016 | ||||||||
| LastUpdateDate: | 01/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 166327 | KY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.