Provider Demographics
NPI:1750625950
Name:STANTON, KATHRYN SUSAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:SUSAN
Last Name:STANTON
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 1:81 LARSON RD
Mailing Address - Street 2:
Mailing Address - City:UNDERWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98651-9006
Mailing Address - Country:US
Mailing Address - Phone:253-653-2263
Mailing Address - Fax:
Practice Address - Street 1:81 LARSON RD
Practice Address - Street 2:
Practice Address - City:UNDERWOOD
Practice Address - State:WA
Practice Address - Zip Code:98651-9006
Practice Address - Country:US
Practice Address - Phone:253-653-2263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist