Provider Demographics
NPI:1316113384
Name:GLEASON, KATHLEEN E (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:E
Last Name:GLEASON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ELIZABETH
Other - Last Name:DENNEHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 MEANDER ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-2351
Mailing Address - Country:US
Mailing Address - Phone:325-428-6842
Mailing Address - Fax:
Practice Address - Street 1:850 MEANDER ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-2351
Practice Address - Country:US
Practice Address - Phone:325-428-6842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR235Z00000X
CASP 19424235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist