Provider Demographics
NPI:1629581673
Name:MCCREERY-SCARBOR, KATHRYN-LOUISE HENLEY (AUD)
Entity Type:Individual
Prefix:
First Name:KATHRYN-LOUISE
Middle Name:HENLEY
Last Name:MCCREERY-SCARBOR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KATHRYN-LOUISE
Other - Middle Name:HENLEY
Other - Last Name:MCCREERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1410 CHATTANOOGA AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2564
Mailing Address - Country:US
Mailing Address - Phone:706-226-4623
Mailing Address - Fax:706-278-0580
Practice Address - Street 1:1410 CHATTANOOGA AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2564
Practice Address - Country:US
Practice Address - Phone:706-226-4623
Practice Address - Fax:706-278-0580
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004092231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist