Provider Demographics
NPI:1508639956
Name:GERMAN, KATHERINE ROSE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ROSE
Last Name:GERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:PA
Mailing Address - Zip Code:19070-2122
Mailing Address - Country:US
Mailing Address - Phone:610-506-5555
Mailing Address - Fax:
Practice Address - Street 1:15 E SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:RUTLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19070-2122
Practice Address - Country:US
Practice Address - Phone:610-506-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency