Provider Demographics
NPI:1457444796
Name:ADDINGTON, BRENDA S (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:S
Last Name:ADDINGTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 OLD RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-9720
Mailing Address - Country:US
Mailing Address - Phone:859-263-8306
Mailing Address - Fax:
Practice Address - Street 1:6020 OLD RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-9720
Practice Address - Country:US
Practice Address - Phone:859-263-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist