Provider Demographics
NPI:1831713080
Name:RESTREPO, CATHERINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:RESTREPO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:RESTREPO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:900 S FRANKLIN ST, STE 201
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-556-1700
Mailing Address - Fax:
Practice Address - Street 1:900 S FRANKLIN ST, STE 201
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-556-1700
Practice Address - Fax:919-556-1700
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist