Provider Demographics
NPI:1730307414
Name:KACSO, PATRICIA M (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:KACSO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:MACCHIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1909 APPLEGATE CV
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4150
Mailing Address - Country:US
Mailing Address - Phone:407-517-4998
Mailing Address - Fax:866-274-8967
Practice Address - Street 1:1909 APPLEGATE CV
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-4150
Practice Address - Country:US
Practice Address - Phone:407-252-7959
Practice Address - Fax:866-274-8967
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7905235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist