Provider Demographics
NPI:1245561331
Name:NELSON, KATHY (SPEECH THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 COMMONS BLVD
Mailing Address - Street 2:PO BOX 16050
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-3334
Mailing Address - Country:US
Mailing Address - Phone:610-987-2248
Mailing Address - Fax:
Practice Address - Street 1:1111 COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-3334
Practice Address - Country:US
Practice Address - Phone:610-987-2248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist