Provider Demographics
NPI:1487114252
Name:TOFAUTE, KATHERINE A (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:TOFAUTE
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 DUNLOVA CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2114
Mailing Address - Country:US
Mailing Address - Phone:502-526-8311
Mailing Address - Fax:
Practice Address - Street 1:1015 MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2017
Practice Address - Country:US
Practice Address - Phone:502-815-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY140335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist