Provider Demographics
NPI:1346707833
Name:FRAVEL, CATHERINE TAYLOR (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:TAYLOR
Last Name:FRAVEL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 S JEFFERSON FOREST LN
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-8987
Mailing Address - Country:US
Mailing Address - Phone:317-966-4895
Mailing Address - Fax:
Practice Address - Street 1:5286 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3650
Practice Address - Country:US
Practice Address - Phone:540-674-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202009031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist