Provider Demographics
NPI:1710498704
Name:GERETY, JUNE MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:MARIE
Last Name:GERETY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2402
Mailing Address - Country:US
Mailing Address - Phone:785-742-6464
Mailing Address - Fax:785-742-6592
Practice Address - Street 1:201 S 4TH ST.
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434
Practice Address - Country:US
Practice Address - Phone:785-742-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1424235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist