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NPI Code Detail

MEDICARE: MRS. MOLLY KATHLEEN KASPERSKI M.S., CCC-SLP

MEDICARE:  MRS. MOLLY KATHLEEN KASPERSKI  M.S., 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
1235Z00000XSpeech-Language Pathologist146007799IL

General Provider Information

NPI Number : 1598279630
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MOLLY KATHLEEN KASPERSKI M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1009 BOYCE MEMORIAL DR
Second Line :
City : OTTAWA
State : IL
Zip : 61350-2500
Country : US
Telephone Number : 815-433-6433
Fax Number : 815-433-6164
Provider Business Practice Location Address
First Line : 1009 BOYCE MEMORIAL DR
Second Line :
City : OTTAWA
State : IL
Zip : 61350-2500
Country : US
Telephone Number : 815-433-6433
Fax Number : 815-433-6164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2017
Last Update Date : 11/28/2017

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Directions to “ MRS. MOLLY KATHLEEN KASPERSKI M.S., CCC-SLP” Practice Location

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