MEDICARE: TINA H KEMP M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2001024934	MO

General Provider Information

NPI Number	:	1194960344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA H KEMP M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	8630 N OAK TRFY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2471
Country	:	US
Telephone Number	:	816-420-9005
Fax Number	:

Provider Business Practice Location Address
First Line	:	8630 N OAK TRFY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2471
Country	:	US
Telephone Number	:	816-420-9005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2008
Last Update Date	:	12/02/2008

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Directions to “ TINA H KEMP M.A., CCC-SLP” Practice Location

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