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NPI Code Detail

MEDICARE: MS. MARY KATHLEEN KRATER M.A., CCC-SLP

MEDICARE: MS. MARY KATHLEEN KRATER M.A., CCC-SLP
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
1235Z00000XSpeech-Language PathologistSP2633CA

General Provider Information

NPI Number : 1386898658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY KATHLEEN KRATER M.A., CCC-SLP
Provider Business Mailing Address
First Line : 630 S INDIAN HILL BLVD STE 5
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-5461
Country : US
Telephone Number : 909-451-8521
Fax Number :
Provider Business Practice Location Address
First Line : 630 S INDIAN HILL BLVD STE 5
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-5461
Country : US
Telephone Number : 909-451-8521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2008
Last Update Date : 03/30/2023

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