Pam Craft
Individual provider Active NPI Speech-Language Pathologist · Walker, MO
NPI 1417123514 · NPPES record last updated May 8, 2008
Key facts
- NPI
- 1417123514
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2006014625 (MO)
- Practice address
- 216 E Leslie Ave
Walker, MO 64790-9177 - Phone
- (417) 465-2221
- NPI assigned
- May 8, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 2006014625 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Vernon County School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2006014625 | MO | Yes |
Addresses
Primary practice location
216 E Leslie Ave
Walker, MO 64790-9177
Mailing address
216 E Leslie Ave
Walker, MO 64790-9177
Phone (417) 465-2221
Other providers in Walker, MO
All providers in Walker, 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 May 8, 2008. 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.