Provider Demographics
NPI:1588107692
Name:GARD, KATHRYN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:GARD
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 1:8101 CARTER ST APT 2105
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1377
Mailing Address - Country:US
Mailing Address - Phone:785-550-8014
Mailing Address - Fax:
Practice Address - Street 1:7850 FREEMAN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2133
Practice Address - Country:US
Practice Address - Phone:913-334-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist