Provider Demographics
NPI:1437424850
Name:KATHLEEN M KRONENWETTER
Entity Type:Organization
Organization Name:KATHLEEN M KRONENWETTER
Other - Org Name:OPEN BOOK THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KRONENWETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:1408-394-0638
Mailing Address - Street 1:809 DUNCARDINE WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3517
Mailing Address - Country:US
Mailing Address - Phone:408-394-0638
Mailing Address - Fax:408-749-9828
Practice Address - Street 1:809 DUNCARDINE WAY
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3517
Practice Address - Country:US
Practice Address - Phone:408-394-0638
Practice Address - Fax:408-749-9828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9077235Z00000X
NM5088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty