=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457057366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMPLETE COMMUNICATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2023
-----------------------------------------------------
Last Update Date | 02/02/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4859 SKYLINE DR
-----------------------------------------------------
City | ROELAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66205-1145
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-206-3361
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4859 SKYLINE DR
-----------------------------------------------------
City | ROELAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66205-1145
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-206-3361
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | CHRISTINA CARSON
-----------------------------------------------------
Credential | MA CCC-SLP
-----------------------------------------------------
Telephone | 913-206-3361
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------