Provider Demographics
NPI:1003085101
Name:ADAY, KATIE ELIZABETH (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:ELIZABETH
Last Name:ADAY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:ELIZABETH
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KATIE MULLINS
Mailing Address - Street 1:1617 S 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-7717
Mailing Address - Country:US
Mailing Address - Phone:623-707-2100
Mailing Address - Fax:
Practice Address - Street 1:1339 E 55TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6927
Practice Address - Country:US
Practice Address - Phone:918-417-6424
Practice Address - Fax:918-779-0706
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL4353235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist