MEDICARE: REBEKAH LYNAE FRUNDLE SLP-CFY

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	2017031273	MO

General Provider Information

NPI Number	:	1740792589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH LYNAE FRUNDLE SLP-CFY

Provider Business Mailing Address
First Line	:	10700 INDIANA AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64137-1747
Country	:	US
Telephone Number	:	641-328-4981
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 AGNES AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64127-4129
Country	:	US
Telephone Number	:	816-418-4888
Fax Number	:

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

Provider Enumeration Date	:	11/02/2017
Last Update Date	:	11/02/2017

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Directions to “ REBEKAH LYNAE FRUNDLE SLP-CFY” Practice Location

Language	Start Address	Practice Location

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