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NPI Code Detail

MEDICARE: KATELYN KEATING MACCC-SLP

MEDICARE: KATELYN KEATING MACCC-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 Pathologist2094CO

General Provider Information

NPI Number : 1467807990
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN KEATING MACCC-SLP
Provider Business Mailing Address
First Line : 346 HIGH POINTE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-3283
Country : US
Telephone Number : 970-310-6471
Fax Number :
Provider Business Practice Location Address
First Line : 815 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1844
Country : US
Telephone Number : 970-494-2140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2016
Last Update Date : 05/03/2016

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Directions to “ KATELYN KEATING MACCC-SLP” Practice Location

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