Provider Demographics
NPI:1225765449
Name:KANE, NATALIE M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:KANE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 RAIN CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5538
Mailing Address - Country:US
Mailing Address - Phone:512-423-3768
Mailing Address - Fax:
Practice Address - Street 1:2011 W KOENIG LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1131
Practice Address - Country:US
Practice Address - Phone:512-467-7006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117904235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14258703OtherAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION
TX117904OtherTEXAS DEPARTMENT OF LICENSING & REGISTRATION