Provider Demographics
NPI:1689094229
Name:VANSLUYK, KATRINA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:
Last Name:VANSLUYK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13216 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1426
Mailing Address - Country:US
Mailing Address - Phone:718-427-3217
Mailing Address - Fax:
Practice Address - Street 1:13216 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1426
Practice Address - Country:US
Practice Address - Phone:718-427-3217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist