Provider Demographics
NPI:1184267072
Name:KNAPP, KASSANDRA
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:
Last Name:KNAPP
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 1:1113 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:NE
Mailing Address - Zip Code:68873-1546
Mailing Address - Country:US
Mailing Address - Phone:308-754-4421
Mailing Address - Fax:
Practice Address - Street 1:1113 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:NE
Practice Address - Zip Code:68873-1546
Practice Address - Country:US
Practice Address - Phone:308-754-4421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist