Provider Demographics
NPI:1275048068
Name:BODENSCHATZ, KATLIN RACHELLE (MS-CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATLIN
Middle Name:RACHELLE
Last Name:BODENSCHATZ
Suffix:
Gender:F
Credentials:MS-CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1722
Mailing Address - Country:US
Mailing Address - Phone:814-506-8212
Mailing Address - Fax:
Practice Address - Street 1:138 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8460
Practice Address - Country:US
Practice Address - Phone:814-696-5234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist