Healthcare Provider Details

I. General information

NPI: 1275415978
Provider Name (Legal Business Name): A NEW DAWN SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 N BURNS AVE
VALLEY CENTER KS
67147-2626
US

IV. Provider business mailing address

641 N BURNS AVE
VALLEY CENTER KS
67147-2626
US

V. Phone/Fax

Practice location:
  • Phone: 620-655-2233
  • Fax:
Mailing address:
  • Phone: 620-655-2233
  • Fax:

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: SAMANTHA JENNINGS
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 620-655-2233