Provider Demographics
NPI:1154603694
Name:EPPEIRA, KATHLEEN J
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:J
Last Name:EPPEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4732
Mailing Address - Country:US
Mailing Address - Phone:585-288-2410
Mailing Address - Fax:585-654-1089
Practice Address - Street 1:500 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-4732
Practice Address - Country:US
Practice Address - Phone:585-288-2410
Practice Address - Fax:585-654-1089
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5413-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist