Provider Demographics
NPI:1679727549
Name:SCHOFFSTALL, KATHLEEN M
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:SCHOFFSTALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8561
Mailing Address - Country:US
Mailing Address - Phone:412-369-7447
Mailing Address - Fax:
Practice Address - Street 1:1733 DAWN DR
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8561
Practice Address - Country:US
Practice Address - Phone:412-369-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001969L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist