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General NPI Number Information
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NPI Number | 1194495127
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Entity Type | Individual
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Provider Name | KAILIN LEISURE SCHMIEDESKAMP MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1225 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-977-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 S GRAND BLVD DEPT OF OTOLARYNGOLOGY - GARDEN LEVEL
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City | ST LOUIS
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State | MO
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Zip | 63104-4475
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Country | US
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Telephone | 314-306-5578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2020014761
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License Number State | MO
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