Provider Demographics
NPI:1073172730
Name:PATTERSON, KATIE LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:LYNN
Other - Last Name:HIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 NE 90 AVE
Mailing Address - Street 2:
Mailing Address - City:CLAFLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67525-9149
Mailing Address - Country:US
Mailing Address - Phone:620-282-1936
Mailing Address - Fax:
Practice Address - Street 1:1514 STATE ROAD 96
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-3012
Practice Address - Country:US
Practice Address - Phone:620-792-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist