Provider Demographics
NPI:1487264222
Name:COLBORN, KATELYN NICOLE (AUD)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:NICOLE
Last Name:COLBORN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4372 ELMHURST DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2761
Mailing Address - Country:US
Mailing Address - Phone:614-935-8702
Mailing Address - Fax:
Practice Address - Street 1:4372 ELMHURST DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2761
Practice Address - Country:US
Practice Address - Phone:614-935-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02266231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist