Healthcare Provider Details

I. General information

NPI: 1679331144
Provider Name (Legal Business Name): SUMER S SPRENKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3514 JEFFERSON ST APT 209
KANSAS CITY MO
64111-4812
US

IV. Provider business mailing address

3514 JEFFERSON ST APT 209
KANSAS CITY MO
64111-4812
US

V. Phone/Fax

Practice location:
  • Phone: 913-298-3778
  • Fax:
Mailing address:
  • Phone: 913-298-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2026032010
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: