Provider Demographics
NPI:1609992973
Name:CAHOON, GINGER (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:CAHOON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 BERWICK RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4714
Mailing Address - Country:US
Mailing Address - Phone:336-659-8145
Mailing Address - Fax:336-659-8145
Practice Address - Street 1:1347 BERWICK RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4714
Practice Address - Country:US
Practice Address - Phone:336-659-8145
Practice Address - Fax:336-659-8145
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411912Medicaid