Provider Demographics
NPI:1457546624
Name:KATZ, SHEILA C (MACCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:C
Last Name:KATZ
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 TUCCI WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7091
Mailing Address - Country:US
Mailing Address - Phone:561-642-8852
Mailing Address - Fax:561-642-8852
Practice Address - Street 1:6551 TUCCI WAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7091
Practice Address - Country:US
Practice Address - Phone:561-642-8852
Practice Address - Fax:561-642-8852
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist