Basic Information
| Provider Information | |||||||||
| NPI: | 1235431149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GESCHKE | ||||||||
| FirstName: | KATHY | ||||||||
| MiddleName: | PEDRETTI | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 517 PARKVIEW DR | ||||||||
| Address2: | |||||||||
| City: | WYNNEWOOD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190961643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106672939 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1060 FIRST AVE STE 430 | ||||||||
| Address2: | |||||||||
| City: | KING OF PRUSSIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194061336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109920555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2010 | ||||||||
| LastUpdateDate: | 11/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL001906L | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.