Provider Demographics
NPI:1265666572
Name:KRYZER, KATHERINE M (MA, CC-SP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:M
Last Name:KRYZER
Suffix:
Gender:F
Credentials:MA, CC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25943
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73125-0943
Mailing Address - Country:US
Mailing Address - Phone:316-686-6608
Mailing Address - Fax:316-686-3624
Practice Address - Street 1:9350 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2555
Practice Address - Country:US
Practice Address - Phone:316-686-6608
Practice Address - Fax:316-686-3624
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist