Basic Information
| Provider Information | |||||||||
| NPI: | 1699132373 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHODUS | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | WOLF | ||||||||
| OtherFirstName: | KAY | ||||||||
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| OtherCredential: | SLP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 345 CHAPEL RD | ||||||||
| Address2: | |||||||||
| City: | AMELIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451021713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5133144232 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2400 CLERMONT CENTER DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BATAVIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451031990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137358300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2016 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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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 | OH1282008 | OH | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.