Provider Demographics
NPI:1962290833
Name:PRESTEGARD, KATHERINE CLAIRE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CLAIRE
Last Name:PRESTEGARD
Suffix:
Gender:
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21850 VALIANT DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4728
Mailing Address - Country:US
Mailing Address - Phone:262-957-7174
Mailing Address - Fax:
Practice Address - Street 1:21850 VALIANT DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4728
Practice Address - Country:US
Practice Address - Phone:262-957-7174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist