Provider Demographics
NPI:1063703585
Name:WERLE, KATIE JOSEPHINE (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:JOSEPHINE
Last Name:WERLE
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E COTATI AVE STE F
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-7801
Mailing Address - Country:US
Mailing Address - Phone:707-326-3548
Mailing Address - Fax:
Practice Address - Street 1:315 E COTATI AVE STE F
Practice Address - Street 2:
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-7801
Practice Address - Country:US
Practice Address - Phone:707-326-3548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18913235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist