Provider Demographics
NPI:1205480498
Name:REESE, KATHERINE (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6078 FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1508
Mailing Address - Country:US
Mailing Address - Phone:937-231-0150
Mailing Address - Fax:
Practice Address - Street 1:1120 COTTONWOOD DR STE 4
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7606
Practice Address - Country:US
Practice Address - Phone:513-583-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04714235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty