Provider Demographics
NPI:1134727928
Name:TITZE, KATRINA V (SLPA)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:V
Last Name:TITZE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 TEAKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6529
Mailing Address - Country:US
Mailing Address - Phone:214-972-8126
Mailing Address - Fax:
Practice Address - Street 1:13727 NOEL RD STE 200
Practice Address - Street 2:TOWER 2
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-1338
Practice Address - Country:US
Practice Address - Phone:972-851-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364322355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant