Doctor Name: | MRS. KIM BERENS |
NPI Number: | 1659580637 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MACCC-SLP |
License Number: | 102810 |
Business Practice Address: | 2419 Sw Springwater Rdg Lees Summit, MO - 640812130 |
Business Phone Number: | 8162460120 |
Business Fax Number: | |
Mailing Address: | 2419 Sw Springwater Rdg, LEES SUMMIT |
State: | MO |
Postal Code: | 640812130 |
Phone Number: | 8162460120 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 102810 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |