Provider Demographics
NPI:1174744403
Name:SCOTT, KATHLEEN L (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 DOGWOOD CREEK PL
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-6892
Mailing Address - Country:US
Mailing Address - Phone:919-567-9534
Mailing Address - Fax:919-467-1712
Practice Address - Street 1:875 WALNUT ST
Practice Address - Street 2:SUITE 252
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4215
Practice Address - Country:US
Practice Address - Phone:919-460-0113
Practice Address - Fax:919-467-1712
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist