Provider Demographics
NPI:1134496656
Name:CHADWICK, KRISTEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9215 N VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2381
Mailing Address - Country:US
Mailing Address - Phone:816-804-3026
Mailing Address - Fax:
Practice Address - Street 1:1806 SWIFT AVE
Practice Address - Street 2:STE 110
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3600
Practice Address - Country:US
Practice Address - Phone:816-804-3026
Practice Address - Fax:844-886-3938
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011001406235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist