Provider Demographics
NPI:1376051854
Name:DUVAL, KATHRYN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DUVAL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:MATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10902 CHATHAM RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-4683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6106 HEALTH CENTER LN
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6687
Practice Address - Country:US
Practice Address - Phone:540-785-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist