Provider Demographics
NPI:1912192329
Name:WALDHAUSER, KATHERINE ELAINE (SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELAINE
Last Name:WALDHAUSER
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 1:203 PARISH WALK
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8534
Mailing Address - Country:US
Mailing Address - Phone:803-865-7499
Mailing Address - Fax:803-865-0335
Practice Address - Street 1:203 PARISH WALK
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8534
Practice Address - Country:US
Practice Address - Phone:803-865-7499
Practice Address - Fax:803-865-0335
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist