Provider Demographics
NPI:1457007296
Name:CHILCOTE, KATHARINE ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ELIZABETH
Last Name:CHILCOTE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-4502
Mailing Address - Country:US
Mailing Address - Phone:319-202-4739
Mailing Address - Fax:
Practice Address - Street 1:105 MCCARREN DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1800
Practice Address - Country:US
Practice Address - Phone:563-927-3907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist