Provider Demographics
NPI:1538413141
Name:BARNTS, MATTIE L
Entity type:Individual
Prefix:
First Name:MATTIE
Middle Name:L
Last Name:BARNTS
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 1:6301 N. LUCERNE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-3105
Mailing Address - Country:US
Mailing Address - Phone:816-569-1600
Mailing Address - Fax:816-569-1505
Practice Address - Street 1:6301 N. LUCERNE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-3105
Practice Address - Country:US
Practice Address - Phone:816-569-1600
Practice Address - Fax:816-569-1505
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012031770235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist