NPIMap

Katie R Craddock

Individual provider Active NPI Speech-Language Pathologist · Grain Valley, MO

NPI 1447527296 · NPPES record last updated Nov 22, 2011

Key facts

NPI
1447527296
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2011034018 (MO)
Practice address
31606 N.E. Pink Hill Road
Grain Valley, MO 64029-0304
Phone
(816) 847-5006
Fax
(816) 229-4831
NPI assigned
Nov 22, 2011
Sex
Female
Sole proprietor
No

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
2011034018MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grain Valley R-V School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2011034018 MO Yes

Addresses

Primary practice location

31606 N.E. Pink Hill Road
Grain Valley, MO 64029-0304

Mailing address

31606 N.E. Pink Hill Road
PO Box 304
Grain Valley, MO 64029-0304
Phone (816) 847-5006

Other providers in Grain Valley, MO

All providers in Grain Valley, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.