Provider Demographics
NPI:1447972518
Name:MIKESKA, KATIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MIKESKA
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 1:19006 WHISTLING DUCK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7803
Mailing Address - Country:US
Mailing Address - Phone:361-652-6573
Mailing Address - Fax:
Practice Address - Street 1:6424 SETTLERS VILLAGE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6503
Practice Address - Country:US
Practice Address - Phone:281-345-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107826235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist