Provider Demographics
NPI:1760512198
Name:CHANEY, KIMBERLY CAROL (SLP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:CAROL
Last Name:CHANEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6747 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-3015
Mailing Address - Country:US
Mailing Address - Phone:913-788-8610
Mailing Address - Fax:
Practice Address - Street 1:800 S 55TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-1308
Practice Address - Country:US
Practice Address - Phone:913-288-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist