Provider Demographics
NPI:1013445840
Name:DAVIDSON, KATHRYN ROBERTA (MA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ROBERTA
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 HEATHER HILL BLVD N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-2666
Mailing Address - Country:US
Mailing Address - Phone:513-474-4123
Mailing Address - Fax:
Practice Address - Street 1:2315 HEATHER HILL BLVD N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-2666
Practice Address - Country:US
Practice Address - Phone:513-474-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist