Basic Information
| Provider Information | |||||||||
| NPI: | 1992039358 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PADGETT | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MA/CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 733 WEXFORD WAY | ||||||||
| Address2: | |||||||||
| City: | MADISONVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 424318606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708218001 | ||||||||
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| Practice Location | |||||||||
| Address1: | 921 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422402743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708863656 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2009 | ||||||||
| LastUpdateDate: | 10/01/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 1105 | KY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.