Provider Demographics
NPI:1659705309
Name:HALL, PATRICIA (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SOUTH 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004
Mailing Address - Country:US
Mailing Address - Phone:502-550-3534
Mailing Address - Fax:
Practice Address - Street 1:310 SOUTH 6TH STREET
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004
Practice Address - Country:US
Practice Address - Phone:502-550-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist