MEDICARE: MATTIE L. BARNTS

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	2012031770	MO

General Provider Information

NPI Number	:	1538413141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTIE L. BARNTS

Provider Business Mailing Address
First Line	:	6301 N. LUCERNE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-3105
Country	:	US
Telephone Number	:	816-569-1600
Fax Number	:	816-569-1505

Provider Business Practice Location Address
First Line	:	6301 N. LUCERNE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-3105
Country	:	US
Telephone Number	:	816-569-1600
Fax Number	:	816-569-1505

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

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	11/05/2012

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Directions to “ MATTIE L. BARNTS ” Practice Location

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