Provider Demographics
NPI:1124584040
Name:CULLY, KATHERINE HOWSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HOWSON
Last Name:CULLY
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 1:19 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2012
Mailing Address - Country:US
Mailing Address - Phone:508-612-3831
Mailing Address - Fax:
Practice Address - Street 1:61 LAURIE LN
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2714
Practice Address - Country:US
Practice Address - Phone:508-612-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7724235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist