Medea Marie Boguslaw, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Cameron, MO
NPI 1376527317 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376527317
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2004012746 (MO)
- Practice address
- 1202 W 3Rd St
Cameron, MO 64429-1402 - Phone
- (816) 632-5859
- NPI assigned
- Dec 2, 2005
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2004012746 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2004012746 | MO | Yes |
Addresses
Primary practice location
1202 W 3Rd St
Cameron, MO 64429-1402
Mailing address
1202 W 3Rd St
Cameron, MO 64429-1402
Phone (816) 632-5859
Other providers in Cameron, MO
- William Frank Barker
- Jacob M Barton
- John S Barton III
- Bennett Eyecare Midwest, LLC
- Lindsay Mae Berry
- Marilyn Katherin Bouldin
- Karri April Brady
- Bristol Care, Inc.
- Mary Brown
- Stephanie Caldwell
All providers in Cameron, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.