MRS. KATORYA LATIA BUSH


Address: 330 Avenue C Se, Winter Haven, FL 33880-3243
Phone: 8632682903

MRS. KATORYA LATIA BUSH (NPI# 1144862269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144862269
Entity Type Individual
Full Name MRS. KATORYA LATIA BUSH
Credential SLP-A
Practice Address 330 Avenue C Se
Winter Haven
FL 33880-3243
Mailing Address 3605 Covington Ln
Lakeland
FL 33810-2710
Practice Telephone 8632682903
Mailing Telephone 8138567541
Mailing Fax Number 8639403844
Enumeration Date 2019-10-09
Last Update Date 2019-10-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2355S0801X Specialist/Technologist
Specialization: Speech-Language Assistant
SI4109 FL Speech, Language and Hearing Service Providers

Office Location

Street Address 330 AVENUE C SE
City WINTER HAVEN
State FL
Zip Code 33880-3243

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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 2355S0801X
Grouping Speech, Language and Hearing Service Providers
Classification Specialist/Technologist
Specialization Speech-Language Assistant

Taxonomy Definition

Definition to come...

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Competitor

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City WINTER HAVEN
Zip Code 33880

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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