Provider Demographics
NPI:1194572602
Name:NOVAK, KATHERINE E (BA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:NOVAK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 BUSINESS CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-3434
Mailing Address - Country:US
Mailing Address - Phone:215-293-8882
Mailing Address - Fax:
Practice Address - Street 1:14901 BOGLE DR STE 100
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1736
Practice Address - Country:US
Practice Address - Phone:571-346-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202012169235Z00000X
PASL018737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist