Provider Demographics
NPI:1790152221
Name:ACE THERAPY
Entity Type:Organization
Organization Name:ACE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ATHENA
Authorized Official - Middle Name:VERVILLES
Authorized Official - Last Name:EMERINE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:270-307-1636
Mailing Address - Street 1:28 PADDOCK PT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4310
Mailing Address - Country:US
Mailing Address - Phone:270-307-1636
Mailing Address - Fax:
Practice Address - Street 1:28 PADDOCK PT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4310
Practice Address - Country:US
Practice Address - Phone:270-307-1636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1268235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty