Provider Demographics
NPI:1437356938
Name:RASOR, TOMMIE D (MSCCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TOMMIE
Middle Name:D
Last Name:RASOR
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 BLANDVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-6167
Mailing Address - Country:US
Mailing Address - Phone:270-217-1613
Mailing Address - Fax:
Practice Address - Street 1:867 MCGUIRE AVE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4036
Practice Address - Country:US
Practice Address - Phone:270-442-6168
Practice Address - Fax:270-443-6211
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2948235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12501490Medicaid