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General NPI Number Information
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NPI Number | 1568952935
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Entity Type | Organization
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Legal Business Name | COMMUNICATION STUDIO THERAPY
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 1500 NW MOCK AVE STE C
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City | BLUE SPRINGS
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State | MO
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Zip | 64015-3101
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Country | US
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Telephone | 660-624-0683
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 NW MOCK AVE STE C
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City | BLUE SPRINGS
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State | MO
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Zip | 64015-3101
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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 | OWNER/MEMBER
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Name | NAOMI EVE BRUNNER
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Credential | MS, CCC-SLP
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Telephone | 816-598-8646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 2013000212
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License Number State | MO
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