Provider Demographics
NPI:1942853809
Name:STANTON, AMBERLY NICOLE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMBERLY
Middle Name:NICOLE
Last Name:STANTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11903 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-3504
Mailing Address - Country:US
Mailing Address - Phone:859-802-7001
Mailing Address - Fax:
Practice Address - Street 1:11903 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-3504
Practice Address - Country:US
Practice Address - Phone:859-802-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist