Provider Demographics
NPI:1720469406
Name:CHADWICK SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:CHADWICK SPEECH THERAPY LLC
Other - Org Name:CHADWICK SPEECH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADWICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:816-804-3026
Mailing Address - Street 1:9215 N VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2381
Mailing Address - Country:US
Mailing Address - Phone:816-804-3026
Mailing Address - Fax:
Practice Address - Street 1:9215 N VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2381
Practice Address - Country:US
Practice Address - Phone:816-804-3026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty