Basic Information
| Provider Information | |||||||||
| NPI: | 1346707833 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRAVEL | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | TAYLOR | ||||||||
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| Credential: | M.A., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 S JEFFERSON FOREST LN | ||||||||
| Address2: | |||||||||
| City: | BLACKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240608987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179664895 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5286 ALEXANDER RD | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240843650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406746400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2019 | ||||||||
| LastUpdateDate: | 02/21/2019 | ||||||||
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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 | 2202009031 | VA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.