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NPI Code Detail

MEDICARE: KATHLEEN A RENNIE MA, CCC-SLP-L

MEDICARE: KATHLEEN A RENNIE MA, CCC-SLP-L
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 PathologistSL005067LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2RE1420046OTHERSPEECH LANGUAGE

General Provider Information

NPI Number : 1982829073
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN A RENNIE MA, CCC-SLP-L
Provider Business Mailing Address
First Line : 136 EAST AVE
Second Line :
City : ERIE
State : PA
Zip : 16507-1842
Country : US
Telephone Number : 814-453-7661
Fax Number : 814-455-1132
Provider Business Practice Location Address
First Line : 136 EAST AVE
Second Line :
City : ERIE
State : PA
Zip : 16507-1842
Country : US
Telephone Number : 814-453-7661
Fax Number : 814-455-1132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 10/11/2007

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Directions to “ KATHLEEN A RENNIE MA, CCC-SLP-L” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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