Provider Demographics
NPI:1609871177
Name:VANCE, CATHERINE (MS CCC-A)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:VANCE
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 PINION RD
Mailing Address - Street 2:STE D
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8319
Mailing Address - Country:US
Mailing Address - Phone:775-738-4227
Mailing Address - Fax:775-738-4284
Practice Address - Street 1:1825 PINION RD
Practice Address - Street 2:STE D
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8319
Practice Address - Country:US
Practice Address - Phone:775-738-4227
Practice Address - Fax:775-738-4284
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-129231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003404005Medicaid
NV002304080Medicaid