Doctor Name: | MRS. KATHRYN L SOUTHERN |
NPI Number: | 1689052912 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | 7101001028 |
Business Practice Address: | 2314 Yorkshire Rd Ste 200 Ann Arbor, MI - 481045041 |
Business Phone Number: | 7349739670 |
Business Fax Number: | |
Mailing Address: | 11399 Masters Rd, RILEY |
State: | MI |
Postal Code: | 480412604 |
Phone Number: | 5868173997 |
Fax Number: | |
NPI Enumeration Date: | 05/06/2015 |
NPI Last Update Date: | 05/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7101001028 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |