Basic Information
| Provider Information | |||||||||
| NPI: | 1942686530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRANTHAM | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | KATHERYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11201 MONTGALL AVE APT 1807 | ||||||||
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| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641373503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733447575 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10000 W. 75TH ST., SUITE 250 | ||||||||
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| City: | MERRIAM | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889131910 | ||||||||
| FaxNumber: | 8779131174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2015 | ||||||||
| LastUpdateDate: | 08/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.