Provider Demographics
NPI:1821225491
Name:STANGE, KARA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:STANGE
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 1:2901 S HIDDEN PL APT 12
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-7248
Mailing Address - Country:US
Mailing Address - Phone:605-310-9450
Mailing Address - Fax:
Practice Address - Street 1:2901 S HIDDEN PL APT 12
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-7248
Practice Address - Country:US
Practice Address - Phone:605-310-9450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist