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NPI Code Detail

MEDICARE: MICHELE BRUNGARDT SLP

MEDICARE: MICHELE BRUNGARDT 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
1235Z00000XSpeech-Language Pathologist20090229444MO

General Provider Information

NPI Number : 1669791968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE BRUNGARDT SLP
Provider Business Mailing Address
First Line : 7703 NW BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64153-1731
Country : US
Telephone Number : 816-359-4050
Fax Number : 816-359-4059
Provider Business Practice Location Address
First Line : 7703 NW BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64153-1731
Country : US
Telephone Number : 816-359-4050
Fax Number : 816-359-4059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2010
Last Update Date : 05/26/2010

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Directions to “ MICHELE BRUNGARDT SLP” Practice Location

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