Healthcare Provider Details

I. General information

NPI: 1174400717
Provider Name (Legal Business Name): GRETCHEN ELIZABETH CAPPS SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 E MCCARTY ST
JEFFERSON CITY MO
65101-4855
US

IV. Provider business mailing address

221 FOREST HILLS DR
LOUISIANA MO
63353-2110
US

V. Phone/Fax

Practice location:
  • Phone: 573-659-2600
  • Fax:
Mailing address:
  • Phone: 573-231-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2024038493
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: