Provider Demographics
NPI:1902570641
Name:LENNERS, MARISA MAY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARISA
Middle Name:MAY
Last Name:LENNERS
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 1:15205 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-4966
Mailing Address - Country:US
Mailing Address - Phone:402-350-4950
Mailing Address - Fax:
Practice Address - Street 1:7000 W 121ST ST STE 110
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2011
Practice Address - Country:US
Practice Address - Phone:913-912-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist