Healthcare Provider Details

I. General information

NPI: 1215136007
Provider Name (Legal Business Name): FAYE A. STAAB M.A, CCC-LICENSED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N SOMERSET TER APT 102
OLATHE KS
66062-5529
US

IV. Provider business mailing address

825 N SOMERSET TER APT 102
OLATHE KS
66062-5529
US

V. Phone/Fax

Practice location:
  • Phone: 785-806-1151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number210
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: