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Individual

SAMANTHA PITTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
3101 BROADWAY BLVD, KANSAS CITY, MO 64111-2659
(816) 960-4031
Mailing address
2445 W PARK ST, OLATHE, KS 66061-3893
(620) 899-3096

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4526
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2023043463
MO LICENSE
MO
01
4526
KS LICENSE
KS
Enumeration date
10/09/2023
Last updated
11/12/2023
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