Provider Demographics
NPI:1982452835
Name:THOMPSON, KAELYN BETH
Entity Type:Individual
Prefix:MISS
First Name:KAELYN
Middle Name:BETH
Last Name:THOMPSON
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 1:270 LANCER DR APT 201
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2147
Mailing Address - Country:US
Mailing Address - Phone:606-782-5529
Mailing Address - Fax:
Practice Address - Street 1:117 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-1764
Practice Address - Country:US
Practice Address - Phone:502-316-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist