Provider Demographics
NPI:1922886332
Name:MCCORMICK, KATHERINE LAUREN (MA CF-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LAUREN
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8453 NIGHTHAWK LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9781
Mailing Address - Country:US
Mailing Address - Phone:740-475-9499
Mailing Address - Fax:
Practice Address - Street 1:974 BETHEL RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2467
Practice Address - Country:US
Practice Address - Phone:614-538-2424
Practice Address - Fax:614-538-2418
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist