Provider Demographics
NPI:1174647648
Name:SIMPSON, LISA KAREN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:KAREN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 POLICEMAN WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-8397
Mailing Address - Country:US
Mailing Address - Phone:270-789-9537
Mailing Address - Fax:270-932-9811
Practice Address - Street 1:75 POLICEMAN WAY
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-8397
Practice Address - Country:US
Practice Address - Phone:270-789-9537
Practice Address - Fax:270-932-9811
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist