Basic Information
Provider Information
NPI: 1295486801
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOINER
FirstName: KATHERINE
MiddleName: MORGAN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1900 OAKWOOD CIR
Address2:  
City: JONESBORO
State: AR
PostalCode: 724047755
CountryCode: US
TelephoneNumber: 8707616644
FaxNumber:  
Practice Location
Address1: 151 SOUTHWEST DR
Address2:  
City: JONESBORO
State: AR
PostalCode: 724015828
CountryCode: US
TelephoneNumber: 8709320090
FaxNumber: 8709309336
Other Information
ProviderEnumerationDate: 01/14/2022
LastUpdateDate: 01/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X201406ARY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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