MEDICARE: MISS KATHERINE ELAINE WHITE MA, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	SP.12593	OH

General Provider Information

NPI Number	:	1093231847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KATHERINE ELAINE WHITE MA, CCC-SLP

Provider Business Mailing Address
First Line	:	30 APPLEWOOD CIR
Second Line	:
City	:	OXFORD
State	:	OH
Zip	:	45056-2818
Country	:	US
Telephone Number	:	937-581-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 NW WASHINGTON BLVD
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-5832
Country	:	US
Telephone Number	:	513-896-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2017
Last Update Date	:	03/17/2018

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Directions to “ MISS KATHERINE ELAINE WHITE MA, CCC-SLP” Practice Location

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