Provider Demographics
NPI:1447765904
Name:TERRACCIANO, KATARZYNA WILHELM (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:WILHELM
Last Name:TERRACCIANO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KATARZYNA
Other - Middle Name:
Other - Last Name:WILHELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1900 E KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1924
Mailing Address - Country:US
Mailing Address - Phone:224-612-7618
Mailing Address - Fax:
Practice Address - Street 1:1000 N WOLF RD
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1551
Practice Address - Country:US
Practice Address - Phone:224-612-7618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist