Provider Demographics
NPI:1629277751
Name:CROSS, KATHRYN BRYN (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:BRYN
Last Name:CROSS
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Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1611 JONES FRANKLIN RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3376
Mailing Address - Country:US
Mailing Address - Phone:919-852-0702
Mailing Address - Fax:919-852-0742
Practice Address - Street 1:1611 JONES FRANKLIN RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3376
Practice Address - Country:US
Practice Address - Phone:919-852-0702
Practice Address - Fax:919-852-0742
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7537235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist