Provider Demographics
NPI:1679917256
Name:DAMES, KATHLEEN JENEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:JENEE
Last Name:DAMES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:JENEE
Other - Last Name:BERARDUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS SLP
Mailing Address - Street 1:35 N BALPH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3200
Mailing Address - Country:US
Mailing Address - Phone:412-761-6062
Mailing Address - Fax:
Practice Address - Street 1:35 N BALPH AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:PA
Practice Address - Zip Code:15202-3200
Practice Address - Country:US
Practice Address - Phone:412-761-6062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist