Jayne M Allen, M.S.CCC

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

NPI 1992837405 · NPPES record last updated Jan 10, 2017

Key facts

NPI
1992837405
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1362 (KY)
Practice address
112 Gadwall LN
Winchester, KY 40391-7850
Phone
(859) 771-1593
Fax
(859) 744-0281
NPI assigned
Mar 10, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1362KYMDMental Health Counselor
139846KYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1362 KY Yes
Speech-Language Pathologist 235Z00000X 139846 KY

Addresses

Primary practice location

112 Gadwall LN
Winchester, KY 40391-7850

Mailing address

112 Gadwall LN
Winchester, KY 40391-7850
Phone (859) 771-1593

Other identifiers

IdentifierTypeStateIssuer
7100427200MedicaidKY

Other providers in Winchester, KY

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

Sources for this page

Verify at the official NPI Registry.