Provider Demographics
NPI:1285322883
Name:KITE, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:KITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 ARGYLE RD
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-9563
Mailing Address - Country:US
Mailing Address - Phone:319-795-8735
Mailing Address - Fax:
Practice Address - Street 1:3665 ARGYLE RD
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-9563
Practice Address - Country:US
Practice Address - Phone:319-795-8735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist