Healthcare Provider Details

I. General information

NPI: 1205873023
Provider Name (Legal Business Name): PARAGON SPEECH PATHOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 NW JEFFERSON ST STE A
BLUE SPRINGS MO
64015-8013
US

IV. Provider business mailing address

1214 WOODS CHAPEL RD
BLUE SPRINGS MO
64015-2620
US

V. Phone/Fax

Practice location:
  • Phone: 816-228-4310
  • Fax: 816-228-4365
Mailing address:
  • Phone: 816-228-4310
  • Fax: 816-228-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. JAMIE S RUSSELL
Title or Position: PRESIDENT
Credential: M.S., CCC. SLP
Phone: 816-228-4310