Provider Demographics
NPI:1649246026
Name:ENCHELMAYER, KATHRYN WHITTINGTON (MS, MHSA)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:WHITTINGTON
Last Name:ENCHELMAYER
Suffix:
Gender:F
Credentials:MS, MHSA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:EILEEN
Other - Last Name:WHITTINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MHSA
Mailing Address - Street 1:24 TANYARD CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9411
Mailing Address - Country:US
Mailing Address - Phone:919-929-6717
Mailing Address - Fax:
Practice Address - Street 1:24 TANYARD CT
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9411
Practice Address - Country:US
Practice Address - Phone:919-929-6717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD04273OtherSPEECH-LANG PATHOLOGY LIC
NC9938OtherSPEECH-LANGUAGE PATHOLOGY