Provider Demographics
NPI:1275962466
Name:MITCHELL, KATHARINE ANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ANNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23121 COLTRANE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3959
Mailing Address - Country:US
Mailing Address - Phone:818-624-4001
Mailing Address - Fax:
Practice Address - Street 1:25101 THE OLD RD
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91381-2206
Practice Address - Country:US
Practice Address - Phone:661-249-9940
Practice Address - Fax:661-418-5676
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21109235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist