Dana McCullick

Individual provider Active NPI Speech-Language Pathologist · Frontenac, KS

NPI 1881897239 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1881897239
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2246 (KS)
Practice address
206 S Dittman St
Frontenac, KS 66763-2253
Phone
(615) 896-6400
NPI assigned
Jun 5, 2007
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

LicenseStateTypeSpecialty
2246KSMDSpeech-Language Pathologist
105132MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 105132 MO
Speech-Language Pathologist 235Z00000X 2246 KS Yes

Addresses

Primary practice location

206 S Dittman St
Frontenac, KS 66763-2253

Mailing address

2995 E 770 Rd
El Dorado Springs, MO 64744-8328
Phone (417) 876-5199

Other providers in Frontenac, KS

All providers in Frontenac, KS · Speech-Language Pathologist in Kansas

Sources for this page

Verify at the official NPI Registry.