Provider Demographics
NPI:1225152382
Name:KRIEGSHAUSER, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:KRIEGSHAUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 OLD SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-3913
Mailing Address - Country:US
Mailing Address - Phone:816-316-7060
Mailing Address - Fax:816-316-7113
Practice Address - Street 1:9000 OLD SANTA FE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-3913
Practice Address - Country:US
Practice Address - Phone:816-316-7060
Practice Address - Fax:816-316-7113
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO465766400Medicaid