Provider Demographics
NPI:1659971307
Name:KANE, TINA LYNN
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:LYNN
Last Name:KANE
Suffix:
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 1:6520 NW MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3061
Mailing Address - Country:US
Mailing Address - Phone:580-458-1627
Mailing Address - Fax:
Practice Address - Street 1:9701 MONROVIA ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1564
Practice Address - Country:US
Practice Address - Phone:913-492-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist