Provider Demographics
NPI:1972074805
Name:MOUNT, KATHY R (MS, CCC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:R
Last Name:MOUNT
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2765 CHAPEL PL
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3413
Mailing Address - Country:US
Mailing Address - Phone:859-344-4749
Mailing Address - Fax:859-344-0770
Practice Address - Street 1:2765 CHAPEL PL
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3413
Practice Address - Country:US
Practice Address - Phone:859-344-4749
Practice Address - Fax:859-344-0770
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY141200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist