MEDICARE: KATIE BLOOD 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	121737	TX

General Provider Information

NPI Number	:	1902694789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE BLOOD CCC-SLP

Provider Business Mailing Address
First Line	:	2520 WASHINGTON AVE APT 315
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-4791
Country	:	US
Telephone Number	:	580-461-2483
Fax Number	:

Provider Business Practice Location Address
First Line	:	26865 IH 45 N UNIT 300315
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-4045
Country	:	US
Telephone Number	:	580-461-2483
Fax Number	:

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

Provider Enumeration Date	:	04/30/2025
Last Update Date	:	04/30/2025

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Directions to “ KATIE BLOOD CCC-SLP” Practice Location

Language	Start Address	Practice Location

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