Basic Information
| Provider Information | |||||||||
| NPI: | 1093174393 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | KAJAL | ||||||||
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| Credential: | SLP-CF | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2525 S 135TH AVE | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681442424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023332304 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9012 Q ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681273549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023151000 | ||||||||
| FaxNumber: | 4025595737 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2016 | ||||||||
| LastUpdateDate: | 08/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 235Z00000X | 786 | NE | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.