| Organization Name: | THE KID SPOT CENTER |
| NPI Number: | 1558741884 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE ELIZABETH TRAVIS (SPEECH-LANGUAGE PATHOLOGIST) |
| Mailing Address: | 121 Casey St Ste A Campbellsville |
| State: | KY US |
| Postal Code: | 427186858 |
| Phone Number: | 2704657768 |
| Fax Number: | 2704650068 |
| NPI Enumeration Date: | 06/02/2015 |
| NPI Last Update Date: | 06/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLPINP00216172 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |