Provider Demographics
NPI:1265091979
Name:CHIUMENTO, KATHERINE F (SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:F
Last Name:CHIUMENTO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-3046
Mailing Address - Country:US
Mailing Address - Phone:609-707-2521
Mailing Address - Fax:
Practice Address - Street 1:418 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-3046
Practice Address - Country:US
Practice Address - Phone:096-707-2521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00935700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist