Individual
KATHRYN S CLONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
919 HAYWOOD RD, STE 101, DILLSBORO, NC 28725-0000
(828) 586-1612
(828) 586-0420
Mailing address
919 HAYWOOD RD, STE 101, PO BOX 396, DILLSBORO, NC 28725-0396
(828) 586-1612
(828) 586-0420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5131
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12008121
ASHA
NC
01
—
5131
NC STATE LICENSURE
NC
05
—
7411894
—
NC
Enumeration date
09/19/2007
Last updated
09/11/2009
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