Provider Demographics
NPI:1093015687
Name:STEEN, KATHERINE ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:STEEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:PROCHOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 893787
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-0787
Mailing Address - Country:US
Mailing Address - Phone:601-207-0735
Mailing Address - Fax:808-204-2309
Practice Address - Street 1:95-764 LAUAKI ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2942
Practice Address - Country:US
Practice Address - Phone:601-207-0735
Practice Address - Fax:808-204-2309
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60239632235Z00000X
WASI60172791235Z00000X
HISP-2081235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8912799Medicare PIN