Provider Demographics
NPI:1447916457
Name:GREER, KATHRYN MARIE (MS-CCC, SLP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:GREER
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 1:150 SCHOOL SIDE DR APT B
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-8507
Mailing Address - Country:US
Mailing Address - Phone:270-317-3017
Mailing Address - Fax:
Practice Address - Street 1:750 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1709
Practice Address - Country:US
Practice Address - Phone:270-422-7545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-14
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty