Katelyn Bocken

Individual provider Active NPI Speech-Language Pathologist · Coralville, IA

NPI 1124775952 · NPPES record last updated Mar 2, 2022

Key facts

NPI
1124775952
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
112787 (IA)
Practice address
2350 Oakdale Blvd
Coralville, IA 52241-9702
Phone
(319) 351-5437
NPI assigned
Mar 2, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
112787IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Childserve Clinic Inc Past
since Mar 6, 2022
Accepting new patients
Childserve Therapy, Inc. Speech-Language Pathologist Past
since Mar 6, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 112787 IA Yes

Addresses

Primary practice location

2350 Oakdale Blvd
Coralville, IA 52241-9702

Mailing address

5406 Merle Hay Rd
Johnston, IA 50131-1209
Phone (515) 331-4530

Other providers in Coralville, IA

All providers in Coralville, IA · Speech-Language Pathologist in Iowa

Sources for this page

Verify at the official NPI Registry.