Provider Demographics
NPI:1972952174
Name:BARBARA MARTIN GIFFORD SPEECH THERAPY
Entity Type:Organization
Organization Name:BARBARA MARTIN GIFFORD SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:859-866-1950
Mailing Address - Street 1:967 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-7721
Mailing Address - Country:US
Mailing Address - Phone:859-866-1950
Mailing Address - Fax:859-384-1289
Practice Address - Street 1:967 AUGUSTA CT
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7721
Practice Address - Country:US
Practice Address - Phone:859-866-1950
Practice Address - Fax:859-384-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY141506252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency