Healthcare Provider Details

I. General information

NPI: 1972433019
Provider Name (Legal Business Name): TRISH KONGABLE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13092 DODGEVILLE RD
SPERRY IA
52650-9867
US

IV. Provider business mailing address

13092 DODGEVILLE RD
SPERRY IA
52650-9867
US

V. Phone/Fax

Practice location:
  • Phone: 319-572-0276
  • Fax:
Mailing address:
  • Phone: 319-572-0276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number00718
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: