Provider Demographics
NPI:1710183173
Name:PADGETT, LAURA ANN (MA,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:PADGETT
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 HARRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-2666
Mailing Address - Country:US
Mailing Address - Phone:816-682-2506
Mailing Address - Fax:
Practice Address - Street 1:3609 HARRISON BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-2666
Practice Address - Country:US
Practice Address - Phone:816-682-2506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist