Provider Demographics
NPI:1184963084
Name:PASOS, KATHRYN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PASOS
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2681 HALPERNS WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5625
Mailing Address - Country:US
Mailing Address - Phone:305-773-0982
Mailing Address - Fax:
Practice Address - Street 1:2681 HALPERNS WAY
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5625
Practice Address - Country:US
Practice Address - Phone:305-773-0982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
FLSI20992355S0801X
FLSZ7320235Z00000X
FLSA14661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant