Provider Demographics
NPI:1033728431
Name:POPE, KATHY ANN (MSPA)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:POPE
Suffix:
Gender:F
Credentials:MSPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 REHAB LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8702
Mailing Address - Country:US
Mailing Address - Phone:570-271-8419
Mailing Address - Fax:
Practice Address - Street 1:64 REHAB LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-8702
Practice Address - Country:US
Practice Address - Phone:570-271-8419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000012L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist