Kathryn Vandermolen, | |
1651 E Nickerson Ave, Benton Harbor, MI 49022-2469 | |
(269) 983-5833 | |
(269) 363-4630 |
Full Name | Kathryn Vandermolen |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 1651 E Nickerson Ave, Benton Harbor, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639875131 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 7152000545 (Michigan) | Primary |
Provider Name | Logan Community Resources Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1891917449 PECOS PAC ID: 2961790126 Enrollment ID: O20161004002087 |
Mailing Address | Practice Location Address |
---|---|
Kathryn Vandermolen, 1651 E Nickerson Ave, Benton Harbor, MI 49022-2469 Ph: (269) 983-5833 | Kathryn Vandermolen, 1651 E Nickerson Ave, Benton Harbor, MI 49022-2469 Ph: (269) 983-5833 |
Kinsey Harrison, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 | |
Jessica Gaytan, MS SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-876-5697 | |
Jacqueline Schmitt, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 | |
Anna Patricia Livingston, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 | |
Christopher Lee Smith, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-876-5697 | |
Rachelle Dodge, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-876-5697 Fax: 269-359-3730 |