Provider Demographics
NPI:1447915871
Name:KEFAUVER, AIMEE KATHLEEN (SLP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:KATHLEEN
Last Name:KEFAUVER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:BUSINESS OFFICE - CREDENTIALING
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6379
Mailing Address - Country:US
Mailing Address - Phone:304-243-3124
Mailing Address - Fax:304-243-1131
Practice Address - Street 1:222 N 5TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1582
Practice Address - Country:US
Practice Address - Phone:304-243-8310
Practice Address - Fax:304-243-8430
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist