Basic Information
| Provider Information | |||||||||
| NPI: | 1598269136 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOLL | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 354 | ||||||||
| Address2: | |||||||||
| City: | WEST END | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273760354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106735437 | ||||||||
| FaxNumber: | 9106735438 | ||||||||
| Practice Location | |||||||||
| Address1: | 1163 SEVEN LAKES DR | ||||||||
| Address2: | |||||||||
| City: | WEST END | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106735437 | ||||||||
| FaxNumber: | 9106735438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2018 | ||||||||
| LastUpdateDate: | 03/20/2018 | ||||||||
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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 | 1909011 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.