Provider Demographics
NPI:1467897280
Name:FALK, KATELYN BROOKE
Entity Type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:BROOKE
Last Name:FALK
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KATELYN
Other - Middle Name:BROOKE
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 HAWKINS DRIVE
Mailing Address - Street 2:CENTER FOR DISABILITIES & DEVELOPMENT
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1016
Practice Address - Country:US
Practice Address - Phone:877-686-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist