Provider Demographics
NPI:1790900116
Name:ROWLAND, KATHLEEN D (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:D
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MOORES BEND RD
Mailing Address - Street 2:
Mailing Address - City:CEDARCREEK
Mailing Address - State:MO
Mailing Address - Zip Code:65627-9355
Mailing Address - Country:US
Mailing Address - Phone:417-794-3759
Mailing Address - Fax:
Practice Address - Street 1:302 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:TANEYVILLE
Practice Address - State:MO
Practice Address - Zip Code:65759-5239
Practice Address - Country:US
Practice Address - Phone:417-779-4166
Practice Address - Fax:417-779-2151
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO102263235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist