Provider Demographics
NPI:1770199424
Name:COLEMAN, KATHRYN ANN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ANN
Other - Last Name:MARKOVITS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:421 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PARKESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19365-1405
Mailing Address - Country:US
Mailing Address - Phone:717-449-4711
Mailing Address - Fax:
Practice Address - Street 1:421 3RD AVE
Practice Address - Street 2:
Practice Address - City:PARKESBURG
Practice Address - State:PA
Practice Address - Zip Code:19365-1405
Practice Address - Country:US
Practice Address - Phone:717-449-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL014620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist