Basic Information
Provider Information
NPI: 1164650503
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEINER
FirstName: KATHERINE
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: M.S. CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20 BANKS ST
Address2:  
City: SOMERVILLE
State: MA
PostalCode: 021443105
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 500 CUMMINGS CTR
Address2: SUITE 3850
City: BEVERLY
State: MA
PostalCode: 019156142
CountryCode: US
TelephoneNumber: 9782320332
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2009
LastUpdateDate: 12/08/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X7108MAY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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