Provider Demographics
NPI:1700525532
Name:HAWVER, KATHRYN KELLY (SLP)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:KELLY
Last Name:HAWVER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:KELLY
Other - Last Name:NORMILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:21 TROY RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-1511
Mailing Address - Country:US
Mailing Address - Phone:518-618-6055
Mailing Address - Fax:
Practice Address - Street 1:21 TROY RD
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1511
Practice Address - Country:US
Practice Address - Phone:518-618-6055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007748-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty