Provider Demographics
NPI:1477983294
Name:GADY, KACY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KACY
Middle Name:
Last Name:GADY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KACY
Other - Middle Name:
Other - Last Name:WINEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:31 1/2 LYMAN RD
Mailing Address - Street 2:APT B
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060
Mailing Address - Country:US
Mailing Address - Phone:574-847-9094
Mailing Address - Fax:
Practice Address - Street 1:31 1/2 HALF LYMAN RD
Practice Address - Street 2:APT B
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:574-847-9094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-9033-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist