Provider Demographics
NPI:1790024859
Name:PLYLER, KATHERINE ANN (M ED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:PLYLER
Suffix:
Gender:F
Credentials:M ED, CCC-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:COLSON
Other - Last Name:PLYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CCC-SLP
Mailing Address - Street 1:3801 SCHROER RD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-7013
Mailing Address - Country:US
Mailing Address - Phone:229-244-3552
Mailing Address - Fax:229-244-7030
Practice Address - Street 1:3801 SCHROER RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-7013
Practice Address - Country:US
Practice Address - Phone:229-244-3552
Practice Address - Fax:229-244-7030
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008083235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist