Provider Demographics
NPI:1063659373
Name:CLEAR COMMUNICATION SPECIALISTS
Entity Type:Organization
Organization Name:CLEAR COMMUNICATION SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:ILENE
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:702-278-3022
Mailing Address - Street 1:6895 E LAKE MEAD BLVD STE 6-126
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-1182
Mailing Address - Country:US
Mailing Address - Phone:702-278-3022
Mailing Address - Fax:702-431-6973
Practice Address - Street 1:6895 E LAKE MEAD BLVD STE 6-126
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89156-1182
Practice Address - Country:US
Practice Address - Phone:702-278-3022
Practice Address - Fax:702-431-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty