| Doctor Name: | MS. PERVEEN M KATRACK |
| NPI Number: | 1992056154 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 15203 |
| Business Practice Address: | 23504 Lyons Ave Suite 103 B Newhall, CA - 913212500 |
| Business Phone Number: | 6612530245 |
| Business Fax Number: | 6612530310 |
| Mailing Address: | 28564 Ives Ct, SAUGUS |
| State: | CA |
| Postal Code: | 913503883 |
| Phone Number: | 6613099539 |
| Fax Number: | 6616449247 |
| NPI Enumeration Date: | 09/27/2012 |
| NPI Last Update Date: | 09/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 15203 |
| 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 |