Provider Demographics
NPI:1285761494
Name:CLIFTON, MONICA M (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12178 S SHANNAN LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5968
Mailing Address - Country:US
Mailing Address - Phone:913-634-9534
Mailing Address - Fax:913-768-0228
Practice Address - Street 1:12178 S SHANNAN LN
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5968
Practice Address - Country:US
Practice Address - Phone:913-634-9534
Practice Address - Fax:913-768-0228
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1109235Z00000X
MO108632235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist