MEDICARE: MRS. CATHERINE RAE WOIDTKE M.S., 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	445495	MN
2	235Z00000X	Speech-Language Pathologist	000029956	ND

General Provider Information

NPI Number	:	1124449418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE RAE WOIDTKE M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	7418 LONG POINT DR NW
Second Line	:
City	:	WILLIAMS
State	:	MN
Zip	:	56686-4501
Country	:	US
Telephone Number	:	218-783-7366
Fax Number	:

Provider Business Practice Location Address
First Line	:	7418 LONG POINT DR NW
Second Line	:
City	:	WILLIAMS
State	:	MN
Zip	:	56686-4501
Country	:	US
Telephone Number	:	218-783-7366
Fax Number	:

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

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	01/03/2014

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Directions to “ MRS. CATHERINE RAE WOIDTKE M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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