Provider Demographics
NPI:1114610839
Name:KIRSCH, KASSIDY JEANNE (MS ED CF-SLP)
Entity Type:Individual
Prefix:
First Name:KASSIDY
Middle Name:JEANNE
Last Name:KIRSCH
Suffix:
Gender:F
Credentials:MS ED CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N CAMBELL ST STE A
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-1726
Mailing Address - Country:US
Mailing Address - Phone:605-716-2634
Mailing Address - Fax:
Practice Address - Street 1:110 N CAMBELL ST STE A
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1726
Practice Address - Country:US
Practice Address - Phone:605-716-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist