Provider Demographics
NPI:1376720177
Name:SULLIVAN, KATHERINE WALSH (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:WALSH
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:PHD, 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:WALTER REED ARMY MEDICAL CENTER ATTN: MCHL-MAO-C
Mailing Address - Street 2:6900 WALTER REED ARMY MEDICAL CENTER
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20307-0001
Mailing Address - Country:US
Mailing Address - Phone:202-782-6284
Mailing Address - Fax:202-782-4400
Practice Address - Street 1:8901 ROCKVILLE PIKE BETHESDA
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-319-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist