Provider Demographics
NPI:1003430232
Name:WESSELS, KATE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:WESSELS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8630 LEXINGTON AVE APT 336
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3667
Mailing Address - Country:US
Mailing Address - Phone:308-627-6868
Mailing Address - Fax:
Practice Address - Street 1:720 FENWICK ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3122
Practice Address - Country:US
Practice Address - Phone:402-898-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist