Provider Demographics
NPI:1659411759
Name:SPALDING, PATRICIA A II
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:SPALDING
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVENUE CITY R-IX SCHOOL
Mailing Address - Street 2:18069 HWY 169
Mailing Address - City:COSBY
Mailing Address - State:MO
Mailing Address - Zip Code:64436-8115
Mailing Address - Country:US
Mailing Address - Phone:816-662-2305
Mailing Address - Fax:816-662-3201
Practice Address - Street 1:18069 HWY 169
Practice Address - Street 2:
Practice Address - City:COSBY
Practice Address - State:MO
Practice Address - Zip Code:64436-8115
Practice Address - Country:US
Practice Address - Phone:816-662-2305
Practice Address - Fax:816-662-3201
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003002520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist