Provider Demographics
NPI:1710184353
Name:KLUCK, CATHY R (MED, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:R
Last Name:KLUCK
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 CAUSEWAY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-5523
Mailing Address - Country:US
Mailing Address - Phone:814-437-0147
Mailing Address - Fax:
Practice Address - Street 1:351 CAUSEWAY DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-5523
Practice Address - Country:US
Practice Address - Phone:814-437-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001175L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist