Provider Demographics
NPI:1538280318
Name:HALL, KARI BONNETT (MSCCCSLP)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:BONNETT
Last Name:HALL
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 CORNWALL AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-9171
Mailing Address - Country:US
Mailing Address - Phone:270-725-1816
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1402 CORNWALL AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9171
Practice Address - Country:US
Practice Address - Phone:270-725-1816
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1557235Z00000X
KY142523235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist