Provider Demographics
NPI:1871043240
Name:SKARPHOL, KATHERINE RAE (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:RAE
Last Name:SKARPHOL
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:RAE
Other - Last Name:FINDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9810 DREW AVE S APT 103
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2762
Mailing Address - Country:US
Mailing Address - Phone:612-257-0535
Mailing Address - Fax:
Practice Address - Street 1:9810 DREW AVE S APT 103
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-2762
Practice Address - Country:US
Practice Address - Phone:612-257-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN496522235Z00000X
TX19713235Z00000X
MN9750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN496522OtherMINNESOTA DEPARTMENT OF EDUCATION
MN9750OtherMN BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY