MEDICARE: ADVANTAGE SPEECH SERVICES LC

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	115070	MO

General Provider Information

NPI Number	:	1467594424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE SPEECH SERVICES LC

Provider Business Mailing Address
First Line	:	8503 NE 110TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-1139
Country	:	US
Telephone Number	:	816-407-0700
Fax Number	:	816-407-0700

Provider Business Practice Location Address
First Line	:	8503 NE 110TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-1139
Country	:	US
Telephone Number	:	816-407-0700
Fax Number	:	816-407-0700

Authorized Official
Title or Position	:	MEMBEROWNER
Name	:	MRS. JENNIFER ANNE LANE LEHR
Credential	:	M.S. CCC-SLP
Telephone Number	:	816-407-0700

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	08/22/2020

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