NPI 1104709104 · live from the CMS NPI Registry
Bluegrass Speech & Swallowing Outpatient Therapy LLC
Speech-Language Pathologist, in London, KY. National Provider Identifier 1104709104, active.
NPI record
| NPI | 1104709104 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 202 W 7th St Ste 203, London, KY 40741 |
| Practice phone | 606-309-4982 |
| Mailing address | 452 Brannon Mill Rd, Lily, KY 40740 |
| Enumerated | July 28, 2025 |
| Last updated | August 19, 2026 |
| Authorized official | Kailyn Baker, Owner/Speech Language Pathologist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Physical Therapist | 225100000X | — |
| Physical Therapy Assistant | 225200000X | — |
| Occupational Therapist | 225X00000X | — |
| Speech-Language Pathologist, primary | 235Z00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.