Provider Demographics
NPI:1629118591
Name:KAUFFELD, MARCI JO (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARCI
Middle Name:JO
Last Name:KAUFFELD
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 1:509 LANGLEY TRCE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-6742
Mailing Address - Country:US
Mailing Address - Phone:270-234-6629
Mailing Address - Fax:
Practice Address - Street 1:509 LANGLEY TRCE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-6742
Practice Address - Country:US
Practice Address - Phone:270-234-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist