Provider Demographics
NPI:1245698901
Name:VAN DEN HUL, KATIE ANN
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:ANN
Last Name:VAN DEN HUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 LINCOLN ST NE
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3318
Mailing Address - Country:US
Mailing Address - Phone:712-546-4101
Mailing Address - Fax:712-546-5060
Practice Address - Street 1:1140 LINCOLN ST NE
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3318
Practice Address - Country:US
Practice Address - Phone:712-546-4101
Practice Address - Fax:712-546-5060
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA081026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist