Provider Demographics
NPI:1245711852
Name:BRAVERMAN, KATHLEEN MONTECALVO (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MONTECALVO
Last Name:BRAVERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 WOOD MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-3070
Mailing Address - Country:US
Mailing Address - Phone:513-271-9408
Mailing Address - Fax:513-751-9813
Practice Address - Street 1:1960 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1884
Practice Address - Country:US
Practice Address - Phone:513-751-5880
Practice Address - Fax:513-751-9813
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-0310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist