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Individual

MS. MACKENZIE RAE GROSS

Active
Sole proprietor
Yes

Provider details

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

Contact information

Practice address
427 W MAIN ST, GARDNER, KS 66030-1183
(913) 856-8747
Mailing address
8441 W 131ST PL APT 633, OVERLAND PARK, KS 66213-5116
(817) 881-2811

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3553
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
23
KS
Enumeration date
05/11/2020
Last updated
05/11/2020
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