Provider Demographics
NPI:1891271631
Name:PAYNE, LISA FELTNER (SLP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:FELTNER
Last Name:PAYNE
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 1:293 GOLDEN POND DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-7807
Mailing Address - Country:US
Mailing Address - Phone:606-767-2095
Mailing Address - Fax:606-862-4633
Practice Address - Street 1:293 GOLDEN POND DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-7807
Practice Address - Country:US
Practice Address - Phone:606-767-2095
Practice Address - Fax:606-862-4633
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist