Provider Demographics
NPI:1003833914
Name:BUNTING, HEIDI
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:BUNTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 COLLEGE BLVD STE 370
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1886
Mailing Address - Country:US
Mailing Address - Phone:913-696-5750
Mailing Address - Fax:913-696-5761
Practice Address - Street 1:5520 COLLEGE BLVD STE 370
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1886
Practice Address - Country:US
Practice Address - Phone:913-696-5750
Practice Address - Fax:913-696-5761
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO119636235Z00000X
KS3062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO465056521Medicaid