Basic Information
| Provider Information | |||||||||
| NPI: | 1639706831 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT-VANDEUSEN | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 927 ACADEMY PL | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152432023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126576814 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3240 WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | CANONSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153173180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249414434 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2020 | ||||||||
| LastUpdateDate: | 03/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL004867L | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.