Provider Demographics
NPI:1275157752
Name:RICHARDSON, CASEY KATHARINE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:KATHARINE
Last Name:RICHARDSON
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 1:1515 HOLCOMBE BLVD UNIT 340
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:713-745-5816
Mailing Address - Fax:713-792-9893
Practice Address - Street 1:1515 HOLCOMBE BLVD # 340
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:832-829-2549
Practice Address - Fax:713-792-9893
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113006235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist