Provider Demographics
NPI:1174496053
Name:AFFIRMABILITIES PEDIATRIC THERAPY
Entity type:Organization
Organization Name:AFFIRMABILITIES PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:606-259-9259
Mailing Address - Street 1:604 BOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1920
Mailing Address - Country:US
Mailing Address - Phone:606-259-9259
Mailing Address - Fax:606-467-2190
Practice Address - Street 1:132 GLENDALE LN
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1112
Practice Address - Country:US
Practice Address - Phone:606-259-9259
Practice Address - Fax:606-467-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty