Provider Demographics
NPI:1861846503
Name:BLANKEMEIER, KATHERINE VICTORIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:VICTORIA
Last Name:BLANKEMEIER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:VICTORIA
Other - Last Name:BEHRMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:12905 UNION SPRINGS DR
Mailing Address - Street 2:APT 3B
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4448
Mailing Address - Country:US
Mailing Address - Phone:317-809-6803
Mailing Address - Fax:
Practice Address - Street 1:12905 UNION SPRINGS DR APT 3B
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4448
Practice Address - Country:US
Practice Address - Phone:317-809-6803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006305A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist