Provider Demographics
NPI:1730817230
Name:KATANIC, KRISTINA COLLEEN (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:COLLEEN
Last Name:KATANIC
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2203
Mailing Address - Country:US
Mailing Address - Phone:330-264-9699
Mailing Address - Fax:
Practice Address - Street 1:5533 MAHONING AVE FL 2
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2366
Practice Address - Country:US
Practice Address - Phone:330-480-3533
Practice Address - Fax:330-480-3535
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02409231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA.02409Medicaid