Organization
COGNIVANTAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONNIE KATHERINE SLAVYCH PHD, CCC-SLP, ACUE (OWNER)
(501) 412-5621
Entity
Organization
Contact information
Practice address
3322 S CAMPBELL AVE STE CC-3, SPRINGFIELD, MO 65807-4980
(501) 412-5621
Mailing address
3251 N NATIONAL AVE, SPRINGFIELD, MO 65803-4463
(501) 412-5621
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
08/09/2024
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