Basic Information
| Provider Information | |||||||||
| NPI: | 1689058711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENZ | ||||||||
| FirstName: | GINGER | ||||||||
| MiddleName: | LORRAINE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS/CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1820 OAKVIEW RD | ||||||||
| Address2: | WOODLAND OAKS | ||||||||
| City: | ASHLAND | ||||||||
| State: | KY | ||||||||
| PostalCode: | 411011309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063255200 | ||||||||
| FaxNumber: | 6063299143 | ||||||||
| Practice Location | |||||||||
| Address1: | 1820 OAKVIEW RD | ||||||||
| Address2: | WOODLAND OAKS | ||||||||
| City: | ASHLAND | ||||||||
| State: | KY | ||||||||
| PostalCode: | 411011309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063255200 | ||||||||
| FaxNumber: | 6063299143 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2015 | ||||||||
| LastUpdateDate: | 07/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 3904 | KY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.