Provider Demographics
NPI:1619151974
Name:MAHOSKY, KATHERINE ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANN
Last Name:MAHOSKY
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 1:3548 S CHERYL DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-9012
Mailing Address - Country:US
Mailing Address - Phone:928-774-5458
Mailing Address - Fax:
Practice Address - Street 1:3548 S CHERYL DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-9012
Practice Address - Country:US
Practice Address - Phone:928-774-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#SLP0802235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist