Provider Demographics
NPI:1720249154
Name:JAMES, STEPHANIE WIMPSETT (SLP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:WIMPSETT
Last Name:JAMES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WOODHILL RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9166
Mailing Address - Country:US
Mailing Address - Phone:502-424-0048
Mailing Address - Fax:
Practice Address - Street 1:114 WOODHILL RD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9166
Practice Address - Country:US
Practice Address - Phone:502-424-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY08056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist