Provider Demographics
NPI:1669502043
Name:ROYSE, CATHERINE LYNN (MS,CCC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LYNN
Last Name:ROYSE
Suffix:
Gender:F
Credentials:MS,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 582
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339
Mailing Address - Country:US
Mailing Address - Phone:602-237-2468
Mailing Address - Fax:602-237-7365
Practice Address - Street 1:4308 N 51ST AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1914
Practice Address - Country:US
Practice Address - Phone:623-691-1918
Practice Address - Fax:623-691-1920
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0858235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist