Basic Information
| Provider Information | |||||||||
| NPI: | 1750626578 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLOHASZ | ||||||||
| FirstName: | KATELYN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MS-CCC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ASTEDT | ||||||||
| OtherFirstName: | KATELYN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 20435 MONROE ST NE | ||||||||
| Address2: | |||||||||
| City: | CEDAR | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550119418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7636705462 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5200 FAIRVIEW BLVD | ||||||||
| Address2: | |||||||||
| City: | WYOMING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550928013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6519827000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2012 | ||||||||
| LastUpdateDate: | 12/05/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 14051730 | MN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.