Provider Demographics
NPI:1518185230
Name:SIMPSON, MIKE
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 S TOPEKA BLVD
Mailing Address - Street 2:
Mailing Address - City:WAKARUSA
Mailing Address - State:KS
Mailing Address - Zip Code:66546-9633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9535 S TOPEKA BLVD
Practice Address - Street 2:
Practice Address - City:WAKARUSA
Practice Address - State:KS
Practice Address - Zip Code:66546-9633
Practice Address - Country:US
Practice Address - Phone:785-599-7599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS990235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist