Individual
KATE ELIZABETH BANNISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
3307 224TH LN, LONG BEACH, WA 98631-7302
(360) 665-2457
Mailing address
3307 224TH LN, LONG BEACH, WA 98631-7302
(360) 665-2457
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WA
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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