Healthcare Provider Details

I. General information

NPI: 1093631970
Provider Name (Legal Business Name): KC THERAPY COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6741 CLAIRBORNE RD
SHAWNEE KS
66217-9543
US

IV. Provider business mailing address

6741 CLAIRBORNE RD
SHAWNEE KS
66217-9543
US

V. Phone/Fax

Practice location:
  • Phone: 913-228-2629
  • Fax: 913-713-7722
Mailing address:
  • Phone: 913-228-2629
  • Fax: 913-713-7722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BETSY EZELL
Title or Position: OWNER/SPEECH-LANGUAGE PATHOLOGIST
Credential: SLP
Phone: 913-228-2629