Provider Demographics
NPI:1023796679
Name:CUMMINGS, BETTY JEAN (MS-CCC SLP)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MS-CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 WOODBURN ALLEN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:KY
Mailing Address - Zip Code:42170-9724
Mailing Address - Country:US
Mailing Address - Phone:270-779-8061
Mailing Address - Fax:
Practice Address - Street 1:2425 WOODBURN ALLEN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:KY
Practice Address - Zip Code:42170-9724
Practice Address - Country:US
Practice Address - Phone:270-779-8061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY142994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist