Provider Demographics
NPI:1760601900
Name:VECCHIO, KATHERINE CHAFFIN JOHNSTON (MA, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CHAFFIN JOHNSTON
Last Name:VECCHIO
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4209
Mailing Address - Country:US
Mailing Address - Phone:315-767-2224
Mailing Address - Fax:
Practice Address - Street 1:830 WASHINGTON ST
Practice Address - Street 2:SAMARITAN MEDICAL CENTER
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4034
Practice Address - Country:US
Practice Address - Phone:315-785-4088
Practice Address - Fax:315-786-4847
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011128235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist