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General NPI Number Information
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NPI Number | 1871228809
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Entity Type | Individual
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Provider Name | KATHERINE ELIZABETH BOTULA MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 901 CASTRO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3209
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Country | US
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Telephone | 415-255-9395
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Fax |
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Provider Business Mailing Address
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Address Line | 1249A 9TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2306
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Country | US
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Telephone | 802-922-5568
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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 | 32867
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License Number State | CA
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