| Doctor Name: | KATHLEEN M MIKLUSICAK |
| NPI Number: | 1073705059 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC-SLP |
| License Number: | SP0000002140 |
| Business Practice Address: | 1225 E Weisgarber Rd Suite 180 South Knoxville, TN - 379092604 |
| Business Phone Number: | 8655845558 |
| Business Fax Number: | 8655846607 |
| Mailing Address: | 1225 E Weisgarber Rd, Suite 180 South KNOXVILLE |
| State: | TN |
| Postal Code: | 379092604 |
| Phone Number: | 8655845558 |
| Fax Number: | 8655846607 |
| NPI Enumeration Date: | 08/14/2007 |
| NPI Last Update Date: | 08/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP0000002140 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |