Provider Demographics
NPI:1528188562
Name:INFANT-TODDLER SERVICES OF JOHNSON COUNTY
Entity Type:Organization
Organization Name:INFANT-TODDLER SERVICES OF JOHNSON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATNODE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:913-481-8576
Mailing Address - Street 1:12485 S HAGAN LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6066
Mailing Address - Country:US
Mailing Address - Phone:913-481-8576
Mailing Address - Fax:
Practice Address - Street 1:12485 S HAGAN LN
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6066
Practice Address - Country:US
Practice Address - Phone:913-481-8576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty