Renae Dawn Stumpe
Individual provider Active NPI Speech-Language Assistant · Kingdom City, MO
NPI 1124800461 · NPPES record last updated Oct 20, 2023
Key facts
- NPI
- 1124800461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- 2020035811 (MO)
- Practice address
- 2690 Thunderbird Dr
Kingdom City, MO 65262-1816 - Phone
- (573) 386-2214
- Fax
- (573) 386-2169
- NPI assigned
- Oct 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020035811 | MO | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Callaway R-1 School District | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 2020035811 | MO | Yes |
Addresses
Primary practice location
2690 Thunderbird Dr
Kingdom City, MO 65262-1816
Mailing address
5982 Audrain Road 427
Mexico, MO 65265-5521
Phone (573) 473-6096
Other providers in Kingdom City, MO
- North Callaway R-1 School District
- Katherine Marie O'Neal
- Emily Nicole Rowland
- James Lee Smiley
- Stacie Smithee
- Megan Elizabeth Vandewalker
- Katherine Mackenzie White
All providers in Kingdom City, MO · Speech-Language Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.