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General NPI Number Information
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NPI Number | 1255982989
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Entity Type | Individual
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Provider Name | KELSIE K HAVERKAMP M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 1015 AVENIDA CESAR E CHAVEZ
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City | KANSAS CITY
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State | MO
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Zip | 64108-2235
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Country | US
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Telephone | 816-421-1015
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 SE 35TH ST
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City | TOPEKA
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State | KS
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Zip | 66605-2408
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Country | US
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Telephone |
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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 | 2019026221
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License Number State | MO
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