Provider Demographics
NPI:1093462558
Name:HUMADA, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:HUMADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:LYNNE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28727 N FIRETHORNE RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5087
Mailing Address - Country:US
Mailing Address - Phone:281-234-1811
Mailing Address - Fax:
Practice Address - Street 1:28727 N FIRETHORNE RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5087
Practice Address - Country:US
Practice Address - Phone:281-234-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115855235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist