MEDICARE: CLEAR COMMUNICATION SPECIALISTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP-290	NV

General Provider Information

NPI Number	:	1063659373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR COMMUNICATION SPECIALISTS

Provider Business Mailing Address
First Line	:	6895 E LAKE MEAD BLVD STE 6-126
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156-1182
Country	:	US
Telephone Number	:	702-278-3022
Fax Number	:	702-431-6973

Provider Business Practice Location Address
First Line	:	6895 E LAKE MEAD BLVD STE 6-126
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156-1182
Country	:	US
Telephone Number	:	702-278-3022
Fax Number	:	702-431-6973

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST/OWNER
Name	:	MRS. KIM ILENE KOCH
Credential	:	M.S./CCC-SLP
Telephone Number	:	702-278-3022

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	01/09/2009

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Directions to “CLEAR COMMUNICATION SPECIALISTS ” Practice Location

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