Provider Demographics
NPI:1992039358
Name:PADGETT, LAURA V (MA/CCC/SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:V
Last Name:PADGETT
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 1:733 WEXFORD WAY
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-8606
Mailing Address - Country:US
Mailing Address - Phone:270-821-8001
Mailing Address - Fax:
Practice Address - Street 1:921 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2743
Practice Address - Country:US
Practice Address - Phone:270-886-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1105235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist