Provider Demographics
NPI:1841413101
Name:STRAIT, KATHERINE C (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:C
Last Name:STRAIT
Suffix:
Gender:F
Credentials: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:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72525-0694
Mailing Address - Country:US
Mailing Address - Phone:662-719-2625
Mailing Address - Fax:
Practice Address - Street 1:1998 HIGHWAY 62 412
Practice Address - Street 2:SUITE 106
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542-9767
Practice Address - Country:US
Practice Address - Phone:662-719-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP# 2421235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01094815OtherASHA