MEDICARE: SPEECH SWALLOWING AND VOICE CENTER PA

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	1412	KS
2	235Z00000X	Speech-Language Pathologist	2627	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255571964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH SWALLOWING AND VOICE CENTER PA

Provider Business Mailing Address
First Line	:	13213 W 21ST CT STE 104
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67235-9625
Country	:	US
Telephone Number	:	316-573-6802
Fax Number	:	316-721-2291

Provider Business Practice Location Address
First Line	:	13213 W 21ST CT STE 104
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67235-9625
Country	:	US
Telephone Number	:	316-573-6802
Fax Number	:	316-721-2291

Authorized Official
Title or Position	:	OWNER
Name	:	SUSAN LYNN KENNEDY
Credential	:	MS, CCC-SLP
Telephone Number	:	316-573-6802

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	03/21/2023

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Directions to “SPEECH SWALLOWING AND VOICE CENTER PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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