Provider Demographics
NPI:1588869697
Name:KORWATCH, YVONNE NEWPORT
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:NEWPORT
Last Name:KORWATCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:
Other - Last Name:NEWPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3115 E HEBRON LN
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8943
Mailing Address - Country:US
Mailing Address - Phone:502-957-3638
Mailing Address - Fax:
Practice Address - Street 1:3115 E HEBRON LN
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-8943
Practice Address - Country:US
Practice Address - Phone:502-957-3638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist