Provider Demographics
NPI:1558503144
Name:BIEDESS, KATIE ANALENE (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANALENE
Last Name:BIEDESS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CLEARVIEW CT
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8739
Mailing Address - Country:US
Mailing Address - Phone:813-957-6747
Mailing Address - Fax:
Practice Address - Street 1:7380 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4512
Practice Address - Country:US
Practice Address - Phone:727-330-9750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9695235Z00000X
IL146.009649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist