Provider Demographics
NPI:1407422306
Name:TRIPLETT, KATELYN ANGELA (CF-SLP)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANGELA
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11925 W 109TH ST APT 112
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3984
Mailing Address - Country:US
Mailing Address - Phone:417-300-5019
Mailing Address - Fax:
Practice Address - Street 1:10300 INDIAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2484
Practice Address - Country:US
Practice Address - Phone:913-354-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3678235Z00000X
KS235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist