MEDICARE: LAURA PRATHER

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	105036	MO

General Provider Information

NPI Number	:	1578951554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA PRATHER

Provider Business Mailing Address
First Line	:	8020 NE 108TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-8140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8020 NE 108TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-8140
Country	:	US
Telephone Number	:	816-792-2211
Fax Number	:

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

Provider Enumeration Date	:	12/29/2014
Last Update Date	:	12/29/2014

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Directions to “ LAURA PRATHER ” Practice Location

Language	Start Address	Practice Location

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