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NPI Code Detail

MEDICARE: MISS KACI L PATE SLP

MEDICARE: MISS KACI L PATE 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
1235Z00000XSpeech-Language Pathologist102377MO

General Provider Information

NPI Number : 1336184159
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KACI L PATE SLP
Provider Business Mailing Address
First Line : 4206 RETAMA CIR
Second Line :
City : VICTORIA
State : TX
Zip : 77901-2765
Country : US
Telephone Number : 361-582-0611
Fax Number : 361-582-0555
Provider Business Practice Location Address
First Line : 4206 RETAMA CIR
Second Line :
City : VICTORIA
State : TX
Zip : 77901-2765
Country : US
Telephone Number : 361-582-0611
Fax Number : 361-582-0555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2006
Last Update Date : 07/08/2007

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Directions to “ MISS KACI L PATE SLP” Practice Location

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