Provider Demographics
NPI:1407097579
Name:COLE, KATHRYN HOGAN (MSP,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:HOGAN
Last Name:COLE
Suffix:
Gender:F
Credentials:MSP,CCC-SLP
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:HOGAN
Other - Last Name:WENDLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSP,CCC-SLP
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:803-791-2203
Mailing Address - Fax:
Practice Address - Street 1:123 E MEDICAL LN
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4813
Practice Address - Country:US
Practice Address - Phone:803-936-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117822235Z00000X
SC2222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist