MEDICARE: MRS. KATIE MARIE LAFORCE CCC-SLP, ASDCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	15450	NC

General Provider Information

NPI Number	:	1275998551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATIE MARIE LAFORCE CCC-SLP, ASDCS

Provider Business Mailing Address
First Line	:	1307 MURRILL HILL RD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-8671
Country	:	US
Telephone Number	:	803-806-9392
Fax Number	:

Provider Business Practice Location Address
First Line	:	1307 MURRILL HILL RD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-8671
Country	:	US
Telephone Number	:	803-806-9392
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2015
Last Update Date	:	11/10/2025

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