Provider Demographics
NPI:1134918303
Name:ANDERSEN, LILY KATHRYN
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:KATHRYN
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 HUNTERS RDG
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4593
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1920 NC-54
Practice Address - Street 2:SUITE 240, 360
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1577
Practice Address - Country:US
Practice Address - Phone:919-378-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist