Provider Demographics
NPI:1174931745
Name:GARRETT, KATHLEEN ANNE (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANNE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17100 E SHEA BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-6663
Mailing Address - Country:US
Mailing Address - Phone:480-837-4565
Mailing Address - Fax:
Practice Address - Street 1:1300 E 6TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5216
Practice Address - Country:US
Practice Address - Phone:520-225-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP8973235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist