Provider Demographics
NPI:1265046106
Name:AGEL, KATHERINE (SLP-MS-CCC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:AGEL
Suffix:
Gender:F
Credentials:SLP-MS-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 MATHER ST APT 4011
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-3159
Mailing Address - Country:US
Mailing Address - Phone:508-221-4029
Mailing Address - Fax:
Practice Address - Street 1:380 MATHER ST APT 4011
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-3159
Practice Address - Country:US
Practice Address - Phone:508-221-4029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No251S00000XAgenciesCommunity/Behavioral Health