Provider Demographics
NPI:1245440239
Name:BUFALARI, KATHLEEN LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LYNN
Last Name:BUFALARI
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:8814 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-8727
Mailing Address - Country:US
Mailing Address - Phone:540-891-7442
Mailing Address - Fax:
Practice Address - Street 1:1201 SAM PERRY BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4490
Practice Address - Country:US
Practice Address - Phone:540-741-1542
Practice Address - Fax:540-741-1543
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2202003714235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist