Provider Demographics
NPI:1790008985
Name:HAUBERT, KATHERINE (SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HAUBERT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3560 KEMP RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2532
Mailing Address - Country:US
Mailing Address - Phone:937-429-7610
Mailing Address - Fax:
Practice Address - Street 1:3560 KEMP RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2532
Practice Address - Country:US
Practice Address - Phone:937-429-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2009180235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist