Provider Demographics
NPI:1275670978
Name:GALASKA, KATHERINE MARY
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:MARY
Last Name:GALASKA
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 1:5061 W JUPITER WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3625
Mailing Address - Country:US
Mailing Address - Phone:602-326-6555
Mailing Address - Fax:
Practice Address - Street 1:5800 S FOREST AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2816
Practice Address - Country:US
Practice Address - Phone:480-897-2544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist