Provider Demographics
NPI:1841596855
Name:CHAMBERS, KINSEY LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:KINSEY
Middle Name:LYNN
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 BIRDIE CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067-6570
Mailing Address - Country:US
Mailing Address - Phone:859-229-1219
Mailing Address - Fax:
Practice Address - Street 1:320 BIRDIE CT
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40067-6570
Practice Address - Country:US
Practice Address - Phone:859-229-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10-060235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist