Savannah Autem

Individual provider Active NPI Speech-Language Pathologist · Liberty, MO

NPI 1659914745 · NPPES record last updated Oct 22, 2019

Key facts

NPI
1659914745
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2016023418 (MO)
Practice address
1908 Plumbers Way Ste 400
Liberty, MO 64068-7453
Phone
(913) 362-7518
NPI assigned
Oct 22, 2019
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
2016023418MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah a King Ma & Associates Inc Speech-Language Pathologist Past
since Oct 27, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2016023418 MO Yes

Addresses

Primary practice location

1908 Plumbers Way Ste 400
Liberty, MO 64068-7453

Mailing address

10000 W 75TH St Ste 121
Shawnee Mission, KS 66204-2241
Phone (913) 362-7518

Other providers in Liberty, MO

All providers in Liberty, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.