Provider Demographics
NPI:1942679691
Name:AASVED, KATHY RAE (SLP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:RAE
Last Name:AASVED
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 1:8730 MASHIE LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-5412
Mailing Address - Country:US
Mailing Address - Phone:406-493-1841
Mailing Address - Fax:
Practice Address - Street 1:8730 MASHIE LN
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-5412
Practice Address - Country:US
Practice Address - Phone:406-493-1841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist