Provider Demographics
NPI:1831370584
Name:SANNA, KATHLEEN MARIE (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:SANNA
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5372 W WATERWHEEL DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-3132
Mailing Address - Country:US
Mailing Address - Phone:208-407-1877
Mailing Address - Fax:208-567-8850
Practice Address - Street 1:5372 W WATERWHEEL DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-3132
Practice Address - Country:US
Practice Address - Phone:208-407-1877
Practice Address - Fax:208-567-8850
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP1427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist