Katherine Anne Janelle, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Woodruff, SC

NPI 1386077451 · NPPES record last updated Sep 12, 2014

Key facts

NPI
1386077451
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
5360 (SC)
Practice address
200 Lucy P Edwards Rd
Woodruff, SC 29388-8220
Phone
(864) 476-3174
NPI assigned
Aug 13, 2013
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

State licenses

LicenseStateTypeSpecialty
5360SCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5360 SC Yes

Addresses

Primary practice location

200 Lucy P Edwards Rd
Woodruff, SC 29388-8220

Mailing address

200 Lucy P Edwards Rd
Woodruff, SC 29388-8220
Phone (864) 476-3174

Other identifiers

IdentifierTypeStateIssuer
14037987OtherSCAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION: CERTIFICATE OF CLINICAL COMPETENCE
265344OtherSCSOUTH CAROLINA STATE BOARD OF EDUCATION: EDUCATOR LICENSE
5360OtherSCDEPARTMENT OF LLR: BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY

Other providers in Woodruff, SC

All providers in Woodruff, SC · Speech-Language Pathologist in South Carolina

Sources for this page

Verify at the official NPI Registry.