Provider Demographics
NPI:1285011601
Name:GEHA, KATHERYN
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:
Last Name:GEHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LOWELL AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1615
Mailing Address - Country:US
Mailing Address - Phone:413-237-5758
Mailing Address - Fax:
Practice Address - Street 1:38 LOWELL AVE
Practice Address - Street 2:APT 1
Practice Address - City:NEWTONVILLE
Practice Address - State:MA
Practice Address - Zip Code:02460-1615
Practice Address - Country:US
Practice Address - Phone:413-237-5758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP9539SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist