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General NPI Number Information
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NPI Number | 1205550969
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Entity Type | Individual
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Provider Name | KATERINA RAE MS CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1001 SW A AVE
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City | LAWTON
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State | OK
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Zip | 73501-3951
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Country | US
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Telephone | 580-353-8900
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Fax | 580-353-8903
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Provider Business Mailing Address
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Address Line | 300 CORPORATE CENTER DR STE 170
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City | MANALAPAN
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State | NJ
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Zip | 07726-8737
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Country | US
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Telephone | 866-417-8669
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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 | CF511
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License Number State | OK
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