Provider Demographics
NPI:1568967214
Name:ALLEGIANT SPEECH PATHOLOGY
Entity Type:Organization
Organization Name:ALLEGIANT SPEECH PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GUFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:502-420-8750
Mailing Address - Street 1:15505 CRYSTAL VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-6903
Mailing Address - Country:US
Mailing Address - Phone:502-420-8750
Mailing Address - Fax:
Practice Address - Street 1:15505 CRYSTAL VALLEY WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-6903
Practice Address - Country:US
Practice Address - Phone:502-420-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1427553163OtherNPI