Basic Information
| Provider Information | |||||||||
| NPI: | 1952042384 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARMER | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | PAIGE | ||||||||
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| Credential: | MS CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 HOWARD DR | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 400658138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026331007 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6719 STATE ROUTE 564 | ||||||||
| Address2: | |||||||||
| City: | MAYFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420664818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2709702482 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2022 | ||||||||
| LastUpdateDate: | 04/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 252436 | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | F03848559 | 05 | KY | MEDICAID |