Provider Demographics
NPI:1831722479
Name:KUNZWEILER, SYDNEY RIAN (MA, CFY-SLP)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:RIAN
Last Name:KUNZWEILER
Suffix:
Gender:F
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 TOWER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5011
Mailing Address - Country:US
Mailing Address - Phone:605-217-4320
Mailing Address - Fax:605-217-2948
Practice Address - Street 1:4301 SERGEANT RD STE 215
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4710
Practice Address - Country:US
Practice Address - Phone:605-217-4320
Practice Address - Fax:605-217-2948
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
208754692OtherTAX ID