Provider Demographics
NPI:1427246248
Name:WELLINGTON, LIZBETH LEE (MS CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:LIZBETH
Middle Name:LEE
Last Name:WELLINGTON
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 LARIAT RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-2980
Mailing Address - Country:US
Mailing Address - Phone:270-978-1336
Mailing Address - Fax:
Practice Address - Street 1:7815 LARIAT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-2980
Practice Address - Country:US
Practice Address - Phone:270-978-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 3284235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist