Provider Demographics
NPI:1528895232
Name:ZDANOWICZ, KATELYN MARIE
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:ZDANOWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BARTON AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-1030
Mailing Address - Country:US
Mailing Address - Phone:570-463-2206
Mailing Address - Fax:
Practice Address - Street 1:51 ROUTE 204
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8066
Practice Address - Country:US
Practice Address - Phone:570-374-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist