Provider Demographics
NPI:1003181579
Name:MCDONOUGH, KATE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:DARRAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 BRADLEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3536
Mailing Address - Country:US
Mailing Address - Phone:914-282-1462
Mailing Address - Fax:
Practice Address - Street 1:6 BRADLEY ST APT 2
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3536
Practice Address - Country:US
Practice Address - Phone:914-282-1462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033755235Z00000X
CT004639235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist