Provider Demographics
NPI:1811410624
Name:OSTMEYER, KATHERINE (SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:OSTMEYER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:SVOBODA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4601 66TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-4875
Mailing Address - Country:US
Mailing Address - Phone:806-793-3900
Mailing Address - Fax:
Practice Address - Street 1:1133 COLLEGE AVE STE E230
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-587-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113724235Z00000X
KS4304235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113724OtherLICENSE