National Provider Identifier
Katrina Mackenzie Martin, MS-CCL/SLP
Katrina Mackenzie Martin, MS-CCL/SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Fairport, NY and a listed phone number of (585) 377-2230.
Profile Overview
- NPI
- 1437302627
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- October 31, 2008
- Last Updated
- October 22, 2013
Practice Location
- 149 N Main St
- Fairport, NY 14450-1434
Phone: (585) 377-2230
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1437302627
- Entity Type
- Individual
- Last Name
- Martin
- First Name
- Katrina
- Middle Name
- Mackenzie
- Name Prefix
- Mrs.
- Credential
- MS-CCL/SLP
- Provider Other Last Name
- Mackenzie
- Provider Other First Name
- Katie
- Provider Other Middle Name
- Marie
- Provider Other Name Prefix Text
- MS.
- Provider Other Credential Text
- SLP
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 149 N Main St
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-1434
- Mailing Country
- US
- Mailing Phone
- (585) 377-2230
- Mailing Fax
- (585) 377-2312
- Practice Street Address
- 149 N Main St
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-1434
- Practice Country
- US
- Practice Phone
- (585) 377-2230
- Practice Fax
- (585) 377-2312
- Enumeration Date
- October 31, 2008
- Last Updated
- October 22, 2013
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)
- Other Identifiers
- 2468KA (NY)