Wanda Bach, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0962 Issued in KY

Practice address

13415 Highway 30 E
Jackson, KY 41339-7888

Phone

(606) 666-8488

NPI assigned

Apr 27, 2015

Last updated

Apr 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1689051880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13415 HIGHWAY 30 E",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413397888",
            "telephone_number": "606-666-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13415 HIGHWAY 30 E",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413397888",
            "telephone_number": "606-666-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "WANDA",
        "name_prefix": "Mrs.",
        "credential": "CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "0962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Jackson, KY
• Providers in Jackson, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.