Provider Demographics
NPI:1417978933
Name:KEARBY, KARA L (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:L
Last Name:KEARBY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:L
Other - Last Name:PREWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5540 WAYNE 341
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63957-5548
Mailing Address - Country:US
Mailing Address - Phone:573-223-2061
Mailing Address - Fax:
Practice Address - Street 1:5540 WAYNE 341
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-5548
Practice Address - Country:US
Practice Address - Phone:573-223-2061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO119689235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist