Provider Demographics
NPI:1639516867
Name:ADLER, KATIE LYNN (MA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:ADLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:LYNN
Other - Last Name:MCMORROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:840 18TH AVE SE
Mailing Address - Street 2:APT. 202
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2568
Mailing Address - Country:US
Mailing Address - Phone:920-268-9663
Mailing Address - Fax:
Practice Address - Street 1:840 18TH AVE SE
Practice Address - Street 2:APT. 202
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2568
Practice Address - Country:US
Practice Address - Phone:920-268-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist