Sundra Pinson

Individual provider Active NPI Speech-Language Pathologist · De Soto, MO

NPI 1477028082 · NPPES record last updated Oct 10, 2018

Key facts

NPI
1477028082
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
610 Vineland School Rd
De Soto, MO 63020-2561
Phone
(636) 586-1020
NPI assigned
Oct 10, 2018
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

Practice roles

OrganizationSpecialtyStatusNew patients
De Soto Public Schools Past Accepting new patients

Specialties & licenses

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

Addresses

Primary practice location

610 Vineland School Rd
De Soto, MO 63020-2561

Mailing address

610 Vineland School Rd
De Soto, MO 63020-2561
Phone (636) 586-1040

Other names

  • Sundra Nicholson Former name

Other providers in De Soto, MO

All providers in De Soto, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.