Provider Demographics
NPI:1003120908
Name:MARSHALL, KATHERINE SUZANNE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:SUZANNE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 GRAND MESA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-5412
Mailing Address - Country:US
Mailing Address - Phone:719-574-4492
Mailing Address - Fax:
Practice Address - Street 1:6302 GRAND MESA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-5412
Practice Address - Country:US
Practice Address - Phone:719-574-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0430792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist