Healthcare Provider Details

I. General information

NPI: 1366371569
Provider Name (Legal Business Name): FOUNTAIN CITY SPEECH THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4049 PENNSYLVANIA AVE STE 203
KANSAS CITY MO
64111-3022
US

IV. Provider business mailing address

4049 PENNSYLVANIA AVE STE 203
KANSAS CITY MO
64111-3022
US

V. Phone/Fax

Practice location:
  • Phone: 816-313-2339
  • Fax:
Mailing address:
  • Phone:
  • 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: MICHELLE MCOSKER
Title or Position: OWNER, SPEECH-LANGUAGE PATHOLOGIST
Credential: EDD, CCC-SLP
Phone: 816-313-2339