Katherine Gayle Rudolph
Individual provider Active NPI Speech-Language Pathologist · Flemingsburg, KY
NPI 1003316100 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1003316100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 171789 (KY)
- Practice address
- 115 Pioneer Trce
Flemingsburg, KY 41041-9665 - Phone
- (606) 845-2131
- NPI assigned
- Feb 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26308 | CA | MD | Pediatric Occupational Therapist |
| 171789 | KY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 26308 | CA | |
| Speech-Language Pathologist | 235Z00000X | 171789 | KY | Yes |
Addresses
Primary practice location
115 Pioneer Trce
Flemingsburg, KY 41041-9665
Mailing address
148 Township Road 208
Ironton, OH 45638-8745
Other practice location 1
915 Crenshaw Blvd
Los Angeles, CA 90019-1938
Phone (323) 937-5466
Other providers in Flemingsburg, KY
- Angela Faye Poston
- Jill S. Price
- John Wesley Prince Jr.
- Kimberley K Privett
- Leah Pugh
- Saint Joseph Health System, Inc
- Samuel W. Gehring, PSC
- Mandissa Alicia Sealey
- Holly Sims Sims
- Patricia Smith
All providers in Flemingsburg, KY · Speech-Language Pathologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.