Provider Demographics
NPI:1902051089
Name:DEPAULIS, CATHY LEE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:LEE
Last Name:DEPAULIS
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-2406
Mailing Address - Country:US
Mailing Address - Phone:315-487-8199
Mailing Address - Fax:
Practice Address - Street 1:110 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2406
Practice Address - Country:US
Practice Address - Phone:315-487-8199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013029-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist