Provider Demographics
NPI:1932762796
Name:BEGNOCHE, GWEN ALEXA
Entity Type:Individual
Prefix:
First Name:GWEN
Middle Name:ALEXA
Last Name:BEGNOCHE
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 1:328 N OHIO ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2400
Mailing Address - Country:US
Mailing Address - Phone:785-820-9275
Mailing Address - Fax:785-820-9276
Practice Address - Street 1:328 N OHIO ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2400
Practice Address - Country:US
Practice Address - Phone:785-820-9275
Practice Address - Fax:785-820-9276
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1620237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist