Provider Demographics
NPI:1932866266
Name:SWARINGIM, KATELYN ABIGAIL
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:ABIGAIL
Last Name:SWARINGIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BERRY RD
Mailing Address - Street 2:
Mailing Address - City:BONNE TERRE
Mailing Address - State:MO
Mailing Address - Zip Code:63628-3580
Mailing Address - Country:US
Mailing Address - Phone:573-431-3300
Mailing Address - Fax:
Practice Address - Street 1:300 BERRY RD
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-3580
Practice Address - Country:US
Practice Address - Phone:573-431-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021034432235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist