Provider Demographics
NPI:1225151376
Name:MCCHESNEY, KATHERINE (MACCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:
Last Name:MCCHESNEY
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 PEACHTREE PKWY
Mailing Address - Street 2:SUITE E207
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6034
Mailing Address - Country:US
Mailing Address - Phone:404-509-6303
Mailing Address - Fax:
Practice Address - Street 1:3651 PEACHTREE PKWY
Practice Address - Street 2:SUITE E207
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6034
Practice Address - Country:US
Practice Address - Phone:404-509-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006504235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA848476042AMedicaid