Provider Demographics
NPI:1285156174
Name:KATZEN, SALLY S-C (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SALLY
Middle Name:S-C
Last Name:KATZEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 WESLEYS RUN
Mailing Address - Street 2:
Mailing Address - City:GLADWYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19035-1049
Mailing Address - Country:US
Mailing Address - Phone:215-460-8392
Mailing Address - Fax:
Practice Address - Street 1:1415 WESLEYS RUN
Practice Address - Street 2:
Practice Address - City:GLADWYNE
Practice Address - State:PA
Practice Address - Zip Code:19035-1049
Practice Address - Country:US
Practice Address - Phone:215-460-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist