Individual
MRS. KIM BRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
10300 W 103RD ST STE 300, OVERLAND PARK, KS 66214-2658
(913) 894-1910
(913) 894-1174
Mailing address
12505 S BROUGHAM DR, OLATHE, KS 66062-5248
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2134
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12045045
NATIONAL LICENSE
—
01
—
2134
STATE LICENSE
KS
Enumeration date
02/27/2007
Last updated
07/08/2007
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