Provider Demographics
NPI:1124150107
Name:MANZARI, KIERIN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIERIN
Middle Name:
Last Name:MANZARI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6129 W. 75TH STREET
Mailing Address - Street 2:
Mailing Address - City:PRAINE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208
Mailing Address - Country:US
Mailing Address - Phone:816-898-8834
Mailing Address - Fax:
Practice Address - Street 1:6129 W. 75TH STREET
Practice Address - Street 2:
Practice Address - City:PRAINE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208
Practice Address - Country:US
Practice Address - Phone:816-898-8834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist