Provider Demographics
NPI:1366894727
Name:CAMPA, CATHERINE VERONICA (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:VERONICA
Last Name:CAMPA
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 1:66 SILVER LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4824
Mailing Address - Country:US
Mailing Address - Phone:516-302-5819
Mailing Address - Fax:
Practice Address - Street 1:66 SILVER LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4824
Practice Address - Country:US
Practice Address - Phone:516-302-5819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025822-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist