Provider Demographics
NPI:1043456015
Name:BABINEAU, KATHLEEN MARGARET (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARGARET
Last Name:BABINEAU
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 US HIGHWAY 1 STE 201B
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3763
Mailing Address - Country:US
Mailing Address - Phone:321-735-2135
Mailing Address - Fax:
Practice Address - Street 1:1950 US HIGHWAY 1 STE 201B
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3763
Practice Address - Country:US
Practice Address - Phone:321-291-4498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12425235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist