Provider Demographics
NPI:1740437110
Name:KATAFIASZ, JENNIFER JEAN (AUD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:KATAFIASZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 MADEIRA PINES DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-0017
Mailing Address - Country:US
Mailing Address - Phone:513-349-1351
Mailing Address - Fax:
Practice Address - Street 1:10615 MONTGOMERY RD STE 202
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4460
Practice Address - Country:US
Practice Address - Phone:513-349-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01631231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist