Provider Demographics
NPI:1750626578
Name:PLOHASZ, KATELYN (MS-CCC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:PLOHASZ
Suffix:
Gender:F
Credentials:MS-CCC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:ASTEDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20435 MONROE ST NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR
Mailing Address - State:MN
Mailing Address - Zip Code:55011-9418
Mailing Address - Country:US
Mailing Address - Phone:763-670-5462
Mailing Address - Fax:
Practice Address - Street 1:5200 FAIRVIEW BLVD
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MN
Practice Address - Zip Code:55092-8013
Practice Address - Country:US
Practice Address - Phone:651-982-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14051730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist