Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Anita Maria Vivanco

Individual provider Speech-Language Pathologist · NPI 1558034652

Anita Maria Vivanco is a Speech-Language Pathologist in Clarksville, Indiana. Works from 2 locations. Licensed in Indiana and Kentucky.

Licensed in
IN, KY
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1329 Applegate Ln
Clarksville, IN 47129-9612
Phone: (502) 633-1007
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1800 Neville Dr, Louisville, KY 40216-3820 — (502) 633-1007

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 46003948A (IN)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 271925 (KY)

Record details

NPI number1558034652
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 26, 2021
Last updated in NPPESJuly 27, 2021
Certification dateJuly 27, 2021

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