Jess Cowman

Individual provider Active NPI Speech-Language Pathologist · Radcliff, KY

NPI 1104434653 · NPPES record last updated Jul 21, 2020

Key facts

NPI
1104434653
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
363 W Lincoln Trail Blvd
Radcliff, KY 40160-3302
Phone
(573) 855-7767
NPI assigned
Jul 21, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Early Intervention and Consultation Services, LLC Past
since Aug 2, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

363 W Lincoln Trail Blvd
Radcliff, KY 40160-3302

Mailing address

363 W Lincoln Trail Blvd
Radcliff, KY 40160-3302
Phone (573) 855-7767

Other providers in Radcliff, KY

All providers in Radcliff, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.