Provider Demographics
NPI:1962177360
Name:MCCORMICK, KATHERINE JANE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JANE
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2638 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-5322
Mailing Address - Country:US
Mailing Address - Phone:724-421-6276
Mailing Address - Fax:
Practice Address - Street 1:2638 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-5322
Practice Address - Country:US
Practice Address - Phone:724-421-6276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist