Doctor Name: | KATHRYN MARTIN |
NPI Number: | 1174997944 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 146007145 |
Business Practice Address: | 625 Wham Dr Rm 141 Carbondale, IL - 629014313 |
Business Phone Number: | 6184532361 |
Business Fax Number: | 6184536130 |
Mailing Address: | 625 Wham Dr Rm 141, CARBONDALE |
State: | IL |
Postal Code: | 629014313 |
Phone Number: | 6184532361 |
Fax Number: | 6184536130 |
NPI Enumeration Date: | 11/17/2015 |
NPI Last Update Date: | 11/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146007145 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |