Provider Demographics
NPI:1417201385
Name:MEHTA, SHUCHI KHAROD (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHUCHI
Middle Name:KHAROD
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:SHUCHI
Other - Middle Name:
Other - Last Name:KHAROD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:527 KEISLER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9306
Mailing Address - Country:US
Mailing Address - Phone:919-593-8104
Mailing Address - Fax:919-882-8110
Practice Address - Street 1:527 KEISLER DR STE 204
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9306
Practice Address - Country:US
Practice Address - Phone:919-593-8104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010037367235Z00000X
NC10236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist