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General NPI Number Information
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NPI Number | 1194989301
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Entity Type | Individual
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Provider Name | KATRINA M KAISER
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 297 N BROAD ST
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City | BROOKSVILLE
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State | FL
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Zip | 34601-2925
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Country | US
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Telephone | 352-796-0069
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Fax | 352-796-0069
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Provider Business Mailing Address
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Address Line | 315 NE 10TH AVE
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4456
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Country | US
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Telephone | 352-795-7006
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Fax | 352-795-7008
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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 | SA8184
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License Number State | FL
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