Provider Demographics
NPI:1700462272
Name:REIFFERT, KATRINA BARKETT (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:BARKETT
Last Name:REIFFERT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:MARY
Other - Last Name:BARKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1361 NW 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5312
Mailing Address - Country:US
Mailing Address - Phone:954-683-0624
Mailing Address - Fax:
Practice Address - Street 1:1361 NW 71ST AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-5312
Practice Address - Country:US
Practice Address - Phone:954-683-0624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA14241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist