Provider Demographics
NPI:1437340429
Name:TONKOVICH, KATHRYN II (AUD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:TONKOVICH
Suffix:II
Gender:F
Credentials:AUD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PRIMARY CHILDRENS HOSPITAL AUDIOLOGY DEPT
Mailing Address - Street 2:100 N MARIO CAPPECCI DR
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84113
Mailing Address - Country:US
Mailing Address - Phone:801-662-3277
Mailing Address - Fax:807-662-4930
Practice Address - Street 1:PRIMARY CHILDRENS REHAB BOUNTIFUL
Practice Address - Street 2:280 N MAIN ST
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010
Practice Address - Country:US
Practice Address - Phone:807-397-8707
Practice Address - Fax:801-397-8709
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5366406-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist