Provider Demographics
NPI:1013539212
Name:SALYERS, DEANNA MICHELLE (MS-CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MICHELLE
Last Name:SALYERS
Suffix:
Gender:F
Credentials:MS-CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 COLTS FORK RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-8348
Mailing Address - Country:US
Mailing Address - Phone:606-568-9504
Mailing Address - Fax:
Practice Address - Street 1:850 KY 191
Practice Address - Street 2:
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301-8109
Practice Address - Country:US
Practice Address - Phone:606-668-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY-3159Medicaid