Provider Demographics
NPI:1619978483
Name:EDIGER, RENEE LYNN (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:LYNN
Last Name:EDIGER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LYNN
Other - Last Name:LOEWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:818 N EMPORIA ST
Mailing Address - Street 2:STE 200
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3729
Mailing Address - Country:US
Mailing Address - Phone:316-263-0296
Mailing Address - Fax:316-684-3326
Practice Address - Street 1:310 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-2129
Practice Address - Country:US
Practice Address - Phone:316-684-2838
Practice Address - Fax:316-684-3326
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2001235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115498OtherBCBS OF KANSAS