Provider Demographics
NPI:1346374519
Name:MANNING, KATHRYN FRANCES (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:FRANCES
Last Name:MANNING
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 1:3151 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-0689
Mailing Address - Country:US
Mailing Address - Phone:406-219-3888
Mailing Address - Fax:406-586-8036
Practice Address - Street 1:2135 CHARLOTTE ST STE 3
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-2741
Practice Address - Country:US
Practice Address - Phone:406-586-8030
Practice Address - Fax:406-586-8036
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT820235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT662070OtherBLUE CROSS BLUE SHIELD
MT0534293Medicaid