| Organization Name: | COMMONWEALTH SPEECH & LANGUAGE PATHOLOGY SERVICES |
| NPI Number: | 1639523442 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDY NELSON (SOLE PROPRIETOR/OWNER/SLP) |
| Mailing Address: | 3486 Stamper Dr Winchester |
| State: | KY US |
| Postal Code: | 403911159 |
| Phone Number: | 8593517933 |
| Fax Number: | 8597459463 |
| NPI Enumeration Date: | 04/18/2016 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 0670 |
| 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 |