Provider Demographics
NPI:1659726461
Name:MORA BATAN, KATERIN (MS-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATERIN
Middle Name:
Last Name:MORA BATAN
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 1:17261 NW 94TH CT APT 309
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4371
Mailing Address - Country:US
Mailing Address - Phone:305-302-5457
Mailing Address - Fax:
Practice Address - Street 1:33 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6014
Practice Address - Country:US
Practice Address - Phone:786-601-2042
Practice Address - Fax:786-601-2968
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLSI 28282355S0801X
FLSZ11057235Z00000X
FLSA21818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty