Healthcare Provider Details

I. General information

NPI: 1629989355
Provider Name (Legal Business Name): KATHERINE KINSLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 PRINCE AVE
ATHENS GA
30601-2450
US

IV. Provider business mailing address

152 WOODCREEK PL
ATHENS GA
30605-4410
US

V. Phone/Fax

Practice location:
  • Phone: 706-546-7721
  • Fax:
Mailing address:
  • Phone: 770-296-4586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP008148
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: