Provider Demographics
NPI:1053525428
Name:RICE, VICKI COLLIVER (CCCSLP)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:COLLIVER
Last Name:RICE
Suffix:
Gender:F
Credentials:CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 COUNTRY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-8876
Mailing Address - Country:US
Mailing Address - Phone:859-498-3793
Mailing Address - Fax:859-498-7503
Practice Address - Street 1:1220 COUNTRY HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-8876
Practice Address - Country:US
Practice Address - Phone:859-498-3793
Practice Address - Fax:859-498-7503
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1653OtherCBIS