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General NPI Number Information
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NPI Number | 1063659373
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Entity Type | Organization
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Legal Business Name | CLEAR COMMUNICATION SPECIALISTS
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 6895 E LAKE MEAD BLVD STE 6-126
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City | LAS VEGAS
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State | NV
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Zip | 89156-1182
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Country | US
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Telephone | 702-278-3022
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Fax | 702-431-6973
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Provider Business Mailing Address
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Address Line | 6895 E LAKE MEAD BLVD STE 6-126
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City | LAS VEGAS
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State | NV
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Zip | 89156-1182
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Country | US
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Telephone | 702-278-3022
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Fax | 702-431-6973
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | MRS. KIM ILENE KOCH
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Credential | M.S./CCC-SLP
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Telephone | 702-278-3022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-290
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License Number State | NV
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