Provider Demographics
NPI:1508473018
Name:CAMPAGNA, KATHERINE (MA, CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:CAMPAGNA
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 BLAIR RD APT 104
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4023
Mailing Address - Country:US
Mailing Address - Phone:860-471-2591
Mailing Address - Fax:
Practice Address - Street 1:2601 TOLLEY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-1534
Practice Address - Country:US
Practice Address - Phone:410-396-3426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02185L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist