Provider Demographics
NPI:1518108299
Name:KATICH, RONALD ELI JR (BCHIS)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ELI
Last Name:KATICH
Suffix:JR
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:25237 S SUN LAKES BLVD
Mailing Address - Street 2:8
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-6467
Mailing Address - Country:US
Mailing Address - Phone:480-895-7636
Mailing Address - Fax:480-802-0300
Practice Address - Street 1:25237 S SUN LAKES BLVD
Practice Address - Street 2:8
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-6467
Practice Address - Country:US
Practice Address - Phone:480-895-7636
Practice Address - Fax:480-802-0300
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD1279237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist