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NPI Code Detail

MEDICARE: KATHLEEN MASSARA

MEDICARE: KATHLEEN MASSARA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist1051NE

General Provider Information

NPI Number : 1013204270
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MASSARA
Provider Business Mailing Address
First Line : 1120 WALNUT ST
Second Line :
City : NORTH BEND
State : NE
Zip : 68649-5012
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1120 WALNUT ST
Second Line :
City : NORTH BEND
State : NE
Zip : 68649-5012
Country : US
Telephone Number : 402-216-0315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2011
Last Update Date : 07/07/2011

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Directions to “ KATHLEEN MASSARA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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