Provider Demographics
NPI:1124236344
Name:KOLBE, KATHRYN ANN (MA,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ANN
Last Name:KOLBE
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 GARREN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-8650
Mailing Address - Country:US
Mailing Address - Phone:727-599-8394
Mailing Address - Fax:
Practice Address - Street 1:985 GARREN CREEK RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-8650
Practice Address - Country:US
Practice Address - Phone:727-599-8394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2276235Z00000X
NC12199235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist