Provider Demographics
NPI:1215497599
Name:CHIAVETTA, KATHERINE E
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:CHIAVETTA
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 1:1111 BELLE PRE WAY APT 528
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-6422
Mailing Address - Country:US
Mailing Address - Phone:716-867-5830
Mailing Address - Fax:
Practice Address - Street 1:9010 LORTON STATION BLVD STE 240
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4795
Practice Address - Country:US
Practice Address - Phone:703-337-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist