Provider Demographics
NPI:1093231847
Name:WHITE, KATHERINE ELAINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:ELAINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 APPLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-2818
Mailing Address - Country:US
Mailing Address - Phone:937-581-2455
Mailing Address - Fax:
Practice Address - Street 1:2260 NW WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-5832
Practice Address - Country:US
Practice Address - Phone:513-896-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist