Provider Demographics
NPI:1437486255
Name:EASON, KAY ELLEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:ELLEN
Last Name:EASON
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 1:1622 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3963
Mailing Address - Country:US
Mailing Address - Phone:775-623-4942
Mailing Address - Fax:
Practice Address - Street 1:1622 SCOTT ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3963
Practice Address - Country:US
Practice Address - Phone:775-623-4942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-656235Z00000X
CASP 10551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist