Doctor Name: | MRS. KATHY PETROVIC |
NPI Number: | 1457564031 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SP |
License Number: | 22002016 |
Business Practice Address: | 1980 E 116th St Suite 300 Carmel, IN - 460323599 |
Business Phone Number: | 3178432801 |
Business Fax Number: | 3178432838 |
Mailing Address: | 1980 E 116th St, Suite 300 CARMEL |
State: | IN |
Postal Code: | 460323599 |
Phone Number: | 3178432801 |
Fax Number: | 3178432838 |
NPI Enumeration Date: | 05/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22002016 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |