Provider Demographics
NPI:1679890289
Name:DELANEY, KATHLEEN ELAINE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELAINE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ELAINE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 SHEPHERDS WAY
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-7538
Mailing Address - Country:US
Mailing Address - Phone:513-505-0268
Mailing Address - Fax:
Practice Address - Street 1:310 SHEPHERDS WAY
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-7538
Practice Address - Country:US
Practice Address - Phone:513-505-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12139788235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist