Provider Demographics
NPI:1598141301
Name:MAGAMOLL, KATHRYN MURPHY
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MURPHY
Last Name:MAGAMOLL
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 1:3650 ELOISE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-9007
Mailing Address - Country:US
Mailing Address - Phone:904-477-5375
Mailing Address - Fax:904-355-4149
Practice Address - Street 1:1128 N LAURA ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4912
Practice Address - Country:US
Practice Address - Phone:904-355-3403
Practice Address - Fax:904-355-4149
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ7008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist