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General NPI Number Information
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NPI Number | 1851762579
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Entity Type | Individual
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Provider Name | ELIZABETH KATHERINE EASTMAN M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2015
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 10781 OAK ST
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City | KANSAS CITY
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State | MO
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Zip | 64114-5055
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Country | US
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Telephone | 816-612-4235
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Fax | 816-612-4205
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Provider Business Mailing Address
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Address Line | 7315 HOLMES RD
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City | KANSAS CITY
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State | MO
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Zip | 64131-1650
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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 | 2013033897
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License Number State | MO
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