Provider Demographics
NPI:1730795287
Name:GERARD, KATHRYN CHARLENE (AUD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CHARLENE
Last Name:GERARD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:CHARLENE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:6653 GRAND HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49456
Mailing Address - Country:US
Mailing Address - Phone:231-798-2323
Mailing Address - Fax:231-742-9649
Practice Address - Street 1:6653 GRAND HAVEN RD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49456
Practice Address - Country:US
Practice Address - Phone:231-798-2323
Practice Address - Fax:231-742-9649
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000902231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist