Provider Demographics
NPI:1780200964
Name:GUFFEY, MONICA RAE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RAE
Last Name:GUFFEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 EAGLE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-6733
Mailing Address - Country:US
Mailing Address - Phone:606-278-4655
Mailing Address - Fax:
Practice Address - Street 1:153 HIGH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-1213
Practice Address - Country:US
Practice Address - Phone:606-396-3481
Practice Address - Fax:606-396-3482
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY263182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist