Provider Demographics
NPI:1447412218
Name:SLADE, KATHERINE LANIER (AUD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LANIER
Last Name:SLADE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:BAILEY
Other - Last Name:LANIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7145 HALCYON SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6971
Mailing Address - Country:US
Mailing Address - Phone:334-244-3408
Mailing Address - Fax:334-244-3906
Practice Address - Street 1:7145 HALCYON SUMMIT DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-6971
Practice Address - Country:US
Practice Address - Phone:334-244-3355
Practice Address - Fax:334-244-3906
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003801231H00000X
AL1108A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1108AOtherAL AUDIOLOGY LICENSE
GAAUD003801OtherGA AUDIOLOGY LICENSE