Provider Demographics
NPI:1144582164
Name:SCOTT, KATELYN (MS)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:SCOTT
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 1:3223 YOUNG AVENUE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L0S1N0
Mailing Address - Country:CA
Mailing Address - Phone:289-968-8001
Mailing Address - Fax:
Practice Address - Street 1:150 STAHL RD
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1231
Practice Address - Country:US
Practice Address - Phone:716-629-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist