Provider Demographics
NPI:1619226826
Name:BUJAK, CATHERINE ROSE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ROSE
Last Name:BUJAK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BRITTANY CT
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-8009
Mailing Address - Country:US
Mailing Address - Phone:740-739-9777
Mailing Address - Fax:
Practice Address - Street 1:313 BRITTANY CT
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-8009
Practice Address - Country:US
Practice Address - Phone:740-739-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 10202235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist