Provider Demographics
NPI:1780440354
Name:MIDDLETON, KAY (CPSS CSA)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:CPSS CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3444 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-9056
Mailing Address - Country:US
Mailing Address - Phone:606-401-9148
Mailing Address - Fax:
Practice Address - Street 1:3444 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-9056
Practice Address - Country:US
Practice Address - Phone:606-401-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist