Provider Demographics
NPI:1134958960
Name:BROWN, KATHRYN LUANNE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LUANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 HUNTERCREEK RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2232
Mailing Address - Country:US
Mailing Address - Phone:314-775-8950
Mailing Address - Fax:
Practice Address - Street 1:126 N PAYNE ST
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-1260
Practice Address - Country:US
Practice Address - Phone:636-271-1400
Practice Address - Fax:636-271-1406
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024022645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist