Provider Demographics
NPI:1568763621
Name:ORR, KATERI MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:KATERI
Middle Name:MARIE
Last Name:ORR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 AVIATION RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-2914
Mailing Address - Country:US
Mailing Address - Phone:518-824-1609
Mailing Address - Fax:518-825-1680
Practice Address - Street 1:431 AVIATION RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-2914
Practice Address - Country:US
Practice Address - Phone:518-824-1609
Practice Address - Fax:518-825-1680
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0173961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist