1851500938 NPI number — EAST KENTUCKY SPEECH HEARING AND THERAPY SERVICES

Table of content: MS. MARGARET M. BRENT L.C.P.C. (NPI 1649649575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851500938 NPI number — EAST KENTUCKY SPEECH HEARING AND THERAPY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EAST KENTUCKY SPEECH HEARING AND THERAPY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851500938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1744
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARLAN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40831-5744
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-573-6052
Provider Business Mailing Address Fax Number:
606-573-4030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1148 COLDIRON HTS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAXTER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40806-8419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-573-6052
Provider Business Practice Location Address Fax Number:
606-573-4030
Provider Enumeration Date:
05/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GOSS
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
SPEECH-LANGAUGE PATHOLOGIST
Authorized Official Telephone Number:
606-573-6052

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  0528 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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