Provider Demographics
NPI:1265565386
Name:MONK, KATHERYN SEYMOUR (MS)
Entity type:Individual
Prefix:
First Name:KATHERYN
Middle Name:SEYMOUR
Last Name:MONK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KATHERYN
Other - Middle Name:ANN
Other - Last Name:SEYMOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:500 DONNALLY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1648
Mailing Address - Country:US
Mailing Address - Phone:304-340-2209
Mailing Address - Fax:304-340-2204
Practice Address - Street 1:500 DONNALLY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1648
Practice Address - Country:US
Practice Address - Phone:304-340-2209
Practice Address - Fax:304-340-2204
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0130231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist