Provider Demographics
NPI:1255562708
Name:SOGAS, JENNIFER (CFY-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SOGAS
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 SE HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4334
Mailing Address - Country:US
Mailing Address - Phone:816-289-1807
Mailing Address - Fax:
Practice Address - Street 1:14188 W 150TH CT
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3367
Practice Address - Country:US
Practice Address - Phone:913-829-7775
Practice Address - Fax:913-829-7765
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009014201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist