Provider Demographics
NPI:1194177063
Name:GOLDEY, KATHRYNE (CCC SLP)
Entity type:Individual
Prefix:
First Name:KATHRYNE
Middle Name:
Last Name:GOLDEY
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 CLAIBORNE WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-2730
Mailing Address - Country:US
Mailing Address - Phone:859-771-3665
Mailing Address - Fax:
Practice Address - Street 1:290 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1601
Practice Address - Country:US
Practice Address - Phone:859-218-2322
Practice Address - Fax:859-257-0284
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY166327235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist