Provider Demographics
NPI:1205955200
Name:XEROS, KATIA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATIA
Middle Name:
Last Name:XEROS
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 1:1650 N 42ND CIR APT 310
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-8118
Mailing Address - Country:US
Mailing Address - Phone:781-913-3969
Mailing Address - Fax:
Practice Address - Street 1:2250 INDIAN CREEK BLVD W
Practice Address - Street 2:INDIAN RIVER ESTATES
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-1331
Practice Address - Country:US
Practice Address - Phone:772-562-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7519235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist