Basic Information
| Provider Information | |||||||||
| NPI: | 1730795287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | CHARLENE | ||||||||
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| Credential: | AU.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9561 PETERSON DR | ||||||||
| Address2: | |||||||||
| City: | CADILLAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496019758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2489096396 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1909 N MITCHELL ST | ||||||||
| Address2: | |||||||||
| City: | CADILLAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496011108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894972500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2020 | ||||||||
| LastUpdateDate: | 09/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 1601000902 | MI | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.