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Individual

LINDSEY HEIDRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
3901 RAINBOW BLVD, MAIL STOP 3039, KANSAS CITY, KS 66160
(913) 588-5937
(913) 588-5923
Mailing address
3901 RAINBOW BLVD, MAIL STOP 3039, KANSAS CITY, KS 66160
(913) 588-5937
(913) 588-5923

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
3082
KS
235Z00000X
Speech-Language Pathologist
Primary
6869
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140R4
BLUE CROSS BLUE SHIELD NC
NC
01
188258
MEDCOST PROVIDER ID
NC
01
2010014110
MISSOURI LICENSE
MO
01
3082
STATE OF KANSAS
KS
05
7412354
NC
Enumeration date
02/06/2007
Last updated
10/27/2011
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