Provider Demographics
NPI:1124743976
Name:GRABOWSKI, KATHLEEN MARIE (SC HAS #0684)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:SC HAS #0684
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:AYNOR
Mailing Address - State:SC
Mailing Address - Zip Code:29511-4964
Mailing Address - Country:US
Mailing Address - Phone:843-504-1771
Mailing Address - Fax:
Practice Address - Street 1:153 E N B BAROODY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2523
Practice Address - Country:US
Practice Address - Phone:843-662-7802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0684237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist