Individual
MRS. JENNIFER MICA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
10300 W 103RD ST STE 300, OVERLAND PARK, KS 66214-2658
(913) 894-1910
Mailing address
7403 OSAGE AVE, KANSAS CITY, KS 66111-2718
(913) 522-0251
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2308
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12025978
ASHA LICENSE
—
01
—
2004029819
MO LICENSE
MO
01
—
2308
KS LICENSURE
KS
Enumeration date
05/06/2007
Last updated
07/08/2007
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