Provider Demographics
NPI:1184119919
Name:COSTANTINI TENNER, KATHERINE ELLEN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELLEN
Last Name:COSTANTINI TENNER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ELLEN
Other - Last Name:COSTANTINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:200 Q ST NE APT 2236
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2390
Mailing Address - Country:US
Mailing Address - Phone:410-302-0857
Mailing Address - Fax:
Practice Address - Street 1:3801 CONNECTICUT AVE NW STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008
Practice Address - Country:US
Practice Address - Phone:202-525-1641
Practice Address - Fax:202-299-0590
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist