Provider Demographics
NPI:1871807032
Name:JAPUTRA, KATHARINE E (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:E
Last Name:JAPUTRA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:E
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 MANETTO RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-2339
Mailing Address - Country:US
Mailing Address - Phone:516-694-8664
Mailing Address - Fax:
Practice Address - Street 1:12 MANETTO RD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2339
Practice Address - Country:US
Practice Address - Phone:516-694-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist