Individual
KATELYN KOTLAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
600 MOYE BLVD, ECU PHYSICIANS SPEECH LANGUAGE PATHOLOGY, GREENVILLE, NC 27834-4300
(252) 744-6104
(252) 744-6148
Mailing address
PO BOX 751069, ECU PHYSICIANS, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11633
NC
235Z00000X
Speech-Language Pathologist
9360
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891191607
—
NC
01
—
19EXF
BCBS NC
NC
Enumeration date
11/06/2014
Last updated
03/14/2016
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