MEDICARE: MONICA KEMP MS, CCC-SLP

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	114755	TX

General Provider Information

NPI Number	:	1477113314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA KEMP MS, CCC-SLP

Provider Business Mailing Address
First Line	:	2801 LIVE OAK ST APT 6306
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-5738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11970 N CENTRAL EXPY STE 270
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3770
Country	:	US
Telephone Number	:	972-331-9613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2019
Last Update Date	:	06/13/2019

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Directions to “ MONICA KEMP MS, CCC-SLP” Practice Location

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