Provider Demographics
NPI:1255839189
Name:RENDLEMAN, KATHERINE SARAH (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SARAH
Last Name:RENDLEMAN
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:SARAH
Other - Last Name:CALCATERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2260E S 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:JBLM
Mailing Address - State:WA
Mailing Address - Zip Code:22902
Mailing Address - Country:US
Mailing Address - Phone:618-201-8088
Mailing Address - Fax:
Practice Address - Street 1:6220 S ALASKA ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-1317
Practice Address - Country:US
Practice Address - Phone:253-476-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60801003235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist