Provider Demographics
NPI:1952664344
Name:SIZELOVE, KATHY ANN (LICENSED HEARING SP)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:ANN
Last Name:SIZELOVE
Suffix:
Gender:F
Credentials:LICENSED HEARING SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W STATE ROAD 128
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:IN
Mailing Address - Zip Code:46001-8391
Mailing Address - Country:US
Mailing Address - Phone:765-724-7480
Mailing Address - Fax:
Practice Address - Street 1:116 W STATE ROAD 128
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:IN
Practice Address - Zip Code:46001-8391
Practice Address - Country:US
Practice Address - Phone:765-724-7480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001124A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist