Provider Demographics
NPI:1275235574
Name:KANABY, NATALIE JO (C-SLPA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JO
Last Name:KANABY
Suffix:
Gender:F
Credentials:C-SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:IN
Mailing Address - Zip Code:47981-0214
Mailing Address - Country:US
Mailing Address - Phone:317-626-0139
Mailing Address - Fax:
Practice Address - Street 1:12100 US HIGHWAY 231 S
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:IN
Practice Address - Zip Code:47981-9602
Practice Address - Country:US
Practice Address - Phone:317-626-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist