Provider Demographics
NPI:1619186947
Name:GIRARDIN, KATHRYN D (AUD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:D
Last Name:GIRARDIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 PEQUOT POINT RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-5113
Mailing Address - Country:US
Mailing Address - Phone:413-336-1211
Mailing Address - Fax:
Practice Address - Street 1:575 BEECH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-534-2508
Practice Address - Fax:413-534-2565
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDL341237700000X
MEAP707231H00000X
MA861231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAA58334OtherHARVARD PILGRAM
ME298660099Medicaid
ME023204OtherANTHEM
MA110080696AMedicaid