Provider Demographics
NPI:1780359737
Name:HANEY, KATIE RENEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:RENEE
Last Name:HANEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:RENEE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1033 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-4973
Mailing Address - Country:US
Mailing Address - Phone:724-657-4385
Mailing Address - Fax:
Practice Address - Street 1:1033 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-4973
Practice Address - Country:US
Practice Address - Phone:724-657-4385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MD11121235Z00000X
PASL015951235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist