=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285365494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL ABOUT WORDS SLP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2022
-----------------------------------------------------
Last Update Date | 06/19/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6960 BANNISTER RD
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89436-8192
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-772-5776
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6960 BANNISTER RD
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89436-8192
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-772-5776
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | KRISTINE MARIE KANWETZ
-----------------------------------------------------
Credential | M.S., CCC-SLP
-----------------------------------------------------
Telephone | 775-772-5776
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------