Doctor Name: | KATIE CUSTER |
NPI Number: | 1508231358 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1405 N D St Broken Bow, NE - 688221500 |
Business Phone Number: | 3088701378 |
Business Fax Number: | |
Mailing Address: | 1405 N D St, BROKEN BOW |
State: | NE |
Postal Code: | 688221500 |
Phone Number: | 3088701378 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2015 |
NPI Last Update Date: | 12/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |