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General NPI Number Information
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NPI Number | 1043340516
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Entity Type | Individual
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Provider Name | KATHERINE LOVE TIMLIN SLP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 4875 PALM COAST PKWY NW UNIT 2
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City | PALM COAST
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State | FL
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Zip | 32137-3671
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Country | US
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Telephone | 386-503-4219
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Fax |
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Provider Business Mailing Address
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Address Line | 206 BEACHWAY DR
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City | PALM COAST
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State | FL
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Zip | 32137-8673
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Country | US
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Telephone | 386-503-4219
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Fax | 386-446-7777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA001921
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License Number State | FL
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