Provider Demographics
NPI:1356754758
Name:MOREY, KATHRYN (MASTERS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MOREY
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 S FOUNTAIN GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6431
Mailing Address - Country:US
Mailing Address - Phone:410-459-1110
Mailing Address - Fax:
Practice Address - Street 1:1717 FRONT ST
Practice Address - Street 2:
Practice Address - City:KEESEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12944-3619
Practice Address - Country:US
Practice Address - Phone:518-834-7071
Practice Address - Fax:518-882-0282
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023552235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist