Provider Demographics
NPI:1679639991
Name:SINKS, KATHLEEN MARIE (AUD, ABAC, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARIE
Last Name:SINKS
Suffix:
Gender:F
Credentials:AUD, ABAC, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9835 MANCHESTER RD STE 209
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-1243
Mailing Address - Country:US
Mailing Address - Phone:314-968-4710
Mailing Address - Fax:143-968-4762
Practice Address - Street 1:9835 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-1243
Practice Address - Country:US
Practice Address - Phone:314-968-4710
Practice Address - Fax:314-968-4762
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003006518237600000X
MO2004015178231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO339403008Medicaid