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General NPI Number Information
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NPI Number | 1992272975
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Entity Type | Individual
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Provider Name | KATELYN MARY ACKLEY MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 44 FOSTER RD
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-6178
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Country | US
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Telephone | 845-223-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 102 CUNNINGHAM LN
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City | POUGHQUAG
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State | NY
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Zip | 12570-5609
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Country | US
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Telephone | 845-702-4928
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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 | 028219-1
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License Number State | NY
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