Doctor Name: | KATHLEEN CLANCY |
NPI Number: | 1548649320 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC SLP |
License Number: | 15963 |
Business Practice Address: | 6611 159th Ave Ne Redmond, WA - 980524813 |
Business Phone Number: | 4253268383 |
Business Fax Number: | |
Mailing Address: | Po Box 202, REDMOND |
State: | WA |
Postal Code: | 980730202 |
Phone Number: | 4253268383 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2015 |
NPI Last Update Date: | 03/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 15963 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |