Provider Demographics
NPI:1649949520
Name:MCROBERTS, KATHERINE CAREY (SPEECH-LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CAREY
Last Name:MCROBERTS
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N63W23817 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3152
Mailing Address - Country:US
Mailing Address - Phone:414-202-3233
Mailing Address - Fax:
Practice Address - Street 1:4000 S IH 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7420
Practice Address - Country:US
Practice Address - Phone:414-202-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist