Provider Demographics
NPI:1750802062
Name:COMBS, CASEY (AUD)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-2193
Mailing Address - Country:US
Mailing Address - Phone:316-684-2838
Mailing Address - Fax:316-684-3326
Practice Address - Street 1:310 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-2193
Practice Address - Country:US
Practice Address - Phone:316-684-2838
Practice Address - Fax:316-684-3326
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80981231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist