Provider Demographics
NPI:1922250596
Name:JUNKINS, SALLY PHILLIPS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:PHILLIPS
Last Name:JUNKINS
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 1:90 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8138
Mailing Address - Country:US
Mailing Address - Phone:502-633-1007
Mailing Address - Fax:502-805-1511
Practice Address - Street 1:3761 JOHNSON HALL DR
Practice Address - Street 2:
Practice Address - City:MASONIC HOME
Practice Address - State:KY
Practice Address - Zip Code:40041-9998
Practice Address - Country:US
Practice Address - Phone:502-293-1695
Practice Address - Fax:502-805-1511
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY138564235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist