Provider Demographics
NPI:1033545132
Name:VORPERIAN, KATHLEEN M (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:VORPERIAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:8 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:10505-2023
Mailing Address - Country:US
Mailing Address - Phone:914-439-2378
Mailing Address - Fax:
Practice Address - Street 1:8 VISTA DR
Practice Address - Street 2:
Practice Address - City:BALDWIN PLACE
Practice Address - State:NY
Practice Address - Zip Code:10505-2023
Practice Address - Country:US
Practice Address - Phone:914-439-2378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist