Healthcare Provider Details

I. General information

NPI: 1821278235
Provider Name (Legal Business Name): BARBARA SUE GOTTSCH M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 W 103RD ST SUITE 300
OVERLAND PARK KS
66214-2642
US

IV. Provider business mailing address

11562 HARDY ST
OVERLAND PARK KS
66210-2462
US

V. Phone/Fax

Practice location:
  • Phone: 913-894-1910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number2110
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: