Adrianne Kinchen Funk, MCD CCC SLP

Individual provider Active NPI Speech-Language Pathologist · Arnold, MO

NPI 1275964462 · NPPES record last updated Mar 28, 2014

Key facts

NPI
1275964462
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2013021961 (MO)
Practice address
3488 Jeffco Blvd
Suite 102
Arnold, MO 63010-6015
Phone
(636) 464-5439
Fax
(636) 464-5438
NPI assigned
Dec 12, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2013021961MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2013021961 MO Yes

Addresses

Primary practice location

3488 Jeffco Blvd
Suite 102
Arnold, MO 63010-6015

Mailing address

3488 Jeffco Blvd
Suite 102
Arnold, MO 63010-6015
Phone (636) 464-5439

Other providers in Arnold, MO

All providers in Arnold, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.