Tylease Mechelle Depriest, MA CF-SLP

Individual provider Active NPI Speech-Language Pathologist · El Dorado, KS

NPI 1285237172 · NPPES record last updated Nov 21, 2020

Key facts

NPI
1285237172
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3584 (KS)
Practice address
1313 S High St
El Dorado, KS 67042-3751
Phone
(316) 320-4140
NPI assigned
Nov 21, 2020
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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3584KSMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3584 KS Yes

Addresses

Primary practice location

1313 S High St
El Dorado, KS 67042-3751

Mailing address

5917 N Millsboro St
Park City, KS 67219-1670
Phone (817) 470-1241

Other providers in El Dorado, KS

All providers in El Dorado, KS · Speech-Language Pathologist in Kansas

Sources for this page

Verify at the official NPI Registry.