Katherine V Lewis, MA CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Peru, NY

NPI 1134422801 · NPPES record last updated Oct 15, 2014

Key facts

NPI
1134422801
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
17 School Street
Peru Elementary School
Peru, NY 12972
Phone
(518) 643-6000
Fax
(518) 643-2043
NPI assigned
Dec 17, 2010
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
Credentials
Master of Arts

Specialties & licenses

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

Addresses

Primary practice location

17 School Street
Peru Elementary School
Peru, NY 12972

Mailing address

1717 Front Street
Children'S Development Group
Keeseville, NY 12929
Phone (518) 834-7071

Other identifiers

IdentifierTypeStateIssuer
022563-1OtherNYOFFICE OF PROFESSIONS

Other providers in Peru, NY

All providers in Peru, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.