Provider Demographics
NPI:1720401896
Name:BARRANTES, KASSANDRA CARTER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:CARTER
Last Name:BARRANTES
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 1:2494 PLUM RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40071-9207
Mailing Address - Country:US
Mailing Address - Phone:502-354-3123
Mailing Address - Fax:
Practice Address - Street 1:2494 PLUM RIDGE RD
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40071-9207
Practice Address - Country:US
Practice Address - Phone:502-354-3123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY167289235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist