Individual
KATHLEEN ANNE MCCARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
23078 NE SOCKEYE ST, WOOD VILLAGE, OR 97060-2672
(541) 399-1101
Mailing address
23078 NE SOCKEYE ST, WOOD VILLAGE, OR 97060-2672
(541) 399-1101
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14084881
ASHA CERTIFICATION
—
Enumeration date
11/12/2019
Last updated
11/12/2019
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