Provider Demographics
NPI:1770922908
Name:KRAJEWSKI, KATHRYN (MA/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:KRAJEWSKI
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 VILLA DI ESTE TER
Mailing Address - Street 2:UNIT 204
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1652
Mailing Address - Country:US
Mailing Address - Phone:407-421-1906
Mailing Address - Fax:
Practice Address - Street 1:180 VILLA DI ESTE TER
Practice Address - Street 2:UNIT 204
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1652
Practice Address - Country:US
Practice Address - Phone:407-421-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA4041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist