Provider Demographics
NPI:1710130364
Name:BROSNAHAN, KATHARINE (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:BROSNAHAN
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 1:20 N BROADWAY APT J346
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2154
Mailing Address - Country:US
Mailing Address - Phone:914-772-0744
Mailing Address - Fax:
Practice Address - Street 1:20 N BROADWAY APT J346
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2154
Practice Address - Country:US
Practice Address - Phone:914-772-0744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist