Most Relevant Information
Provider Data
| NPI Number: | 1003535519 |
| Provider Name: | KATRINA BOOM M.A. CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 21164 |
Most Important Dates
| Enumeration Date: | 08/26/2022 |
| Last Updated: | 08/26/2022 |
Provider Practice Location
1251 KNOWLES AVE
CARLSBAD
CA
920081545
Practice Location Phone/Fax
| Phone: | 4089219804 |
| Fax: |
Provider Mailing Location
1251 KNOWLES AVE
CARLSBAD
CA
920081545
Provider Mailing Phone/Fax
| Phone: | 4089219804 |
| Fax: |