MEDICARE: MRS. KATELYN RENEE WAPLES 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.13518	OH

General Provider Information

NPI Number	:	1336520154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATELYN RENEE WAPLES CCC-SLP

Provider Business Mailing Address
First Line	:	9347 WHITE OAK ROAD
Second Line	:
City	:	MOUNT STERLING
State	:	OH
Zip	:	43143
Country	:	US
Telephone Number	:	740-490-8157
Fax Number	:

Provider Business Practice Location Address
First Line	:	9347 WHITE OAK ROAD
Second Line	:
City	:	MOUNT STERLING
State	:	OH
Zip	:	43143
Country	:	US
Telephone Number	:	404-908-1577
Fax Number	:

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

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	09/15/2021

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