Provider Demographics
NPI:1922134873
Name:WEINMANN, CATHY CLARK (SLP)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:CLARK
Last Name:WEINMANN
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 1:728 CANYON RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-3916
Mailing Address - Country:US
Mailing Address - Phone:317-697-1088
Mailing Address - Fax:
Practice Address - Street 1:728 CANYON RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-3916
Practice Address - Country:US
Practice Address - Phone:317-697-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22000194A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist