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General NPI Number Information
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NPI Number | 1114549078
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Entity Type | Individual
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Provider Name | RYLIE A CLATT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 401 3RD ST SW
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City | STATE CENTER
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State | IA
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Zip | 50247-7728
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Country | US
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Telephone | 712-304-1667
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Fax |
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Provider Business Mailing Address
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Address Line | 713 5TH ST
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City | COLO
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State | IA
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Zip | 50056-1027
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Country | US
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Telephone | 712-304-1667
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Fax |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 101046
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License Number State | IA
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