Provider Demographics
NPI:1114409364
Name:CLEMENS, KATHERINE SNOW (MS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SNOW
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 CRESTMONT WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5060
Mailing Address - Country:US
Mailing Address - Phone:770-712-4263
Mailing Address - Fax:
Practice Address - Street 1:140 CIRCLE SLOPE DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5852
Practice Address - Country:US
Practice Address - Phone:770-712-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist