=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407638984
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MADALYNN ANN STAMMER CF-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2023
-----------------------------------------------------
Last Update Date | 07/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 123 E GAY ST STE S1
-----------------------------------------------------
City | WARRENSBURG
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64093-1848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 660-219-9380
-----------------------------------------------------
Fax | 660-219-9380
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 114 SE DOUGLAS ST UNIT 430
-----------------------------------------------------
City | LEES SUMMIT
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64063-3253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-822-7587
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 2025028200
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------