Kathleen C. Anderson, SLPCCC
Individual provider Active NPI Speech-Language Pathologist · Azle, TX
NPI 1124378351 · NPPES record last updated Sep 14, 2012
Key facts
- NPI
- 1124378351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 100277 (TX)
- Practice address
- 15873 Flying Jib Dr.
Azle, TX 76020 - Phone
- (817) 406-4444
- NPI assigned
- Sep 14, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 100277 | TX | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 100277 | TX | Yes |
Addresses
Primary practice location
15873 Flying Jib Dr.
Azle, TX 76020
Mailing address
1573 Flying Jib Dr
Azle, TX 76020-4973
Phone (817) 406-4444
Other providers in Azle, TX
- Albertsons LLC
- Hannah Allen
- Jimmara Anyino Alozie
- Kristi Alverson
- Lindsey Elaine Ames
- Erika Anglemyre
- Archstone Dental-Azle PLLC
- Dorothy Arrington
- Omair Atiq
- Az Health Systems LLC
All providers in Azle, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2012. 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.