Adrienne Chambers

Individual provider Active NPI Speech-Language Pathologist · Kodiak, AK

NPI 1295036051 · NPPES record last updated Apr 14, 2022

Key facts

NPI
1295036051
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
178887 (AK)
Practice address
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone
(907) 486-9870
NPI assigned
Nov 10, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
178887AKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kodiak Cubs Speech Speech-Language Pathologist Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 178887 AK Yes

Addresses

Primary practice location

3449 E Rezanof Dr
Kodiak, AK 99615-6952

Mailing address

3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone (907) 486-9800

Other identifiers

IdentifierTypeStateIssuer
CMG675MedicaidAK

Other providers in Kodiak, AK

All providers in Kodiak, AK · Speech-Language Pathologist in Alaska

Sources for this page

Verify at the official NPI Registry.